CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Genesis Hospital
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $32
- Cash Discount Price: $105
- vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Genesis Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 0.95x the Medicare baseline. Located in 2951 Maple Avenue, Zanesville, OH.
Cash / Self-Pay
$105
Average discount available for prompt cash payment at this facility.
Insurance Median
$32
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$33.73
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $105 (311%)
Insurance Median: $32 (95%)
Cash: $105 (311% of Medicare)
Ins. Median: $32 (95% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $33.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bwc Pending Enablecomp [100544] | $32 | 95% |
| Generic Workers' Comp [10051] | $32 | 95% |
| Mco 3 Hab [100522] | $32 | 95% |
| Mco Advocare [100525] | $32 | 95% |
| Mco Aultcomp [100526] | $32 | 95% |
| Mco Careworks Of Ohio [100122] | $32 | 95% |
| Mco Comp Management Health [100123] | $32 | 95% |
| Mco Comp One [100527] | $32 | 95% |
| Mco Conduent [100545] | $32 | 95% |
| Mco Corvel Group [100124] | $32 | 95% |
| Mco Frank Gates Managed Care [100528] | $32 | 95% |
| Mco Gates Mcdonald [100125] | $32 | 95% |
| Mco Genex Care Of Ohio [100529] | $32 | 95% |
| Mco Hunter Consulting [100546] | $32 | 95% |
| Mco Minute Men Ohiocomp [100524] | $32 | 95% |
| Mco Occupational Health Link, Inc [100521] | $32 | 95% |
| Mco Promedica Medical Mgmt [100531] | $32 | 95% |
| Mco Sedgwick [100206] | $32 | 95% |
| Mco Sheakley Unicare [100127] | $32 | 95% |
| Mco The Health Plan [100176] | $32 | 95% |
| Mco Transportation Claims [100547] | $32 | 95% |
| Mco Travelers Insurance [100548] | $32 | 95% |
| Mco University Hospitals Compcare [100532] | $32 | 95% |
| Mco Workstar Health Srv [100533] | $32 | 95% |
| Spooner Medical Administrators Inc [100126] | $32 | 95% |
| Wc 888 Ohio Comp Lchn [100535] | $32 | 95% |
| Wc Ak Steel Zanesville [10055] | $32 | 95% |
| Wc Avizent Workers Comp [10052] | $32 | 95% |
| Wc Broadspire [100540] | $32 | 95% |
| Wc Bunch & Associates [100537] | $32 | 95% |
| Wc Careworks Consultant [10057] | $32 | 95% |
| Wc Comp Services [10056] | $32 | 95% |
| Wc Compmanagement Inc [10058] | $32 | 95% |
| Wc Constitution State [10059] | $32 | 95% |
| Wc Dollar General Corp [100510] | $32 | 95% |
| Wc Esis 3700 [100538] | $32 | 95% |
| Wc Frank Gates [100541] | $32 | 95% |
| Wc Gallagher Bassett [10053] | $32 | 95% |
| Wc Genesis Hcs Workers Comp [10054] | $32 | 95% |
| Wc Helmsman Management Srv [100536] | $32 | 95% |
| Wc Kroger Co [100512] | $32 | 95% |
| Wc Lear Corp [100513] | $32 | 95% |
| Wc Longaberger [100514] | $32 | 95% |
| Wc Ohio Bwc Black Lung [100534] | $32 | 95% |
| Wc Owen Brockway [100515] | $32 | 95% |
| Wc Pepsi Cola [100539] | $32 | 95% |
| Wc Sedgwick Of Ohio [100516] | $32 | 95% |
| Wc Us Department Of Labor Black Lung Prog [100542] | $32 | 95% |
| Wc Us Post Office [100517] | $32 | 95% |
| Wc Walmart Claims [100518] | $32 | 95% |
| Wc Zandex [100519] | $32 | 95% |
| Select Specialty Hosp Of Se Oh (Alternate) [9991013222] | $80 | 237% |
| Select Specialty Hospital Of Southeast Ohio [1013222] | $80 | 237% |
| Medical Mutual Marketplace [111107] | $82 | 243% |
| Compass Rose Health Plan [10011209] | $101 | 299% |
| United Medical Resources [100153] | $101 | 299% |
| UnitedHealthcare | $101 | 299% |
| Bac [1001100] | $104 | 308% |
| Benefit Services [100114] | $104 | 308% |
| Central States [100118] | $104 | 308% |
| Ebmc [100119] | $104 | 308% |
| Ebs Of Ohio [1001108] | $104 | 308% |
| Employee Benefits [100120] | $104 - $148 | 308% |
| Enterprise Group Planning [1001171] | $104 | 308% |
| Healthscope [100117] | $104 - $110 | 308% |
| Healthsmart Benefit Solutions [1001161] | $104 | 308% |
| Ibew Local [1001168] | $104 | 308% |
| Medical Benefits [100128] | $104 | 308% |
| Mmo [100129] | $104 | 308% |
| Mutual Health Services [10011205] | $104 | 308% |
| Reserve National [1001128] | $104 | 308% |
| Self Funded Plans [100134] | $104 | 308% |
| Upmc Health Plan [10011202] | $104 | 308% |
| Western Southern Financial Group [100190] | $104 | 308% |
| Aetna | $110 | 326% |
| Allied Benefit [100193] | $110 | 326% |
| Assurant Health [100198] | $110 | 326% |
| Chesterfield Resources [1001166] | $110 | 326% |
| Coventry Health Care [1001106] | $110 | 326% |
| Employee Benefit Management Services [1001163] | $110 | 326% |
| Generic Meritain [1001119] | $110 | 326% |
| Healthsmart Payors Organization [1001116] | $110 | 326% |
| Meritain [1001118] | $110 | 326% |
| Nippon Life Benefits [1001169] | $110 | 326% |
| Starmark [1001130] | $110 | 326% |
| Trustmark [1001134] | $110 | 326% |
| Healthplan Upper Ohio Valley [10017] | $136 | 403% |
| Thp Insurance Company [10045] | $136 | 403% |
| Woodmen Assured Life [100171] | $136 | 403% |
| Generic Usa Network [1001114] | $148 | 439% |
| Key Benefit Administrators Inc [10011207] | $148 | 439% |
| Multiplan [1001120] | $148 | 439% |
| Ohio Healthy [1001179] | $148 | 439% |