CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: PAM Rehabilitation Hospital of Dayton LLC

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $38
Cash Discount Price: $158
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at PAM Rehabilitation Hospital of Dayton LLC is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.13x the Medicare baseline. Located in 2310 Crosspointe Dr, Miamisburg, OH.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $158 (468%)

Insurance Median: $38 (113%)

Cash: $158 (468% of Medicare)

Ins. Median: $38 (113% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$21 - $32	62%
Palm Beach Aco Reach	$31	92%
Blue Cross Blue Shield	$32 - $140	95%
Buckeye Community Health Plan	$32 - $44	95%
Caresource	$32 - $44	95%
Humana	$32 - $44	95%
Ilumed Aco Reach	$32	95%
Medical Mutual Of Ohio	$32 - $100	95%
Molina	$32 - $44	95%
The Health Plan	$32	95%
UnitedHealthcare	$32 - $175	95%
Mount Carmel Health Plan	$36	107%
Velocity Provider Ppo Network	$38 - $118	113%
Custom Design Benefits	$44	130%
America'S Choice Provider Network	$110	326%
Quik Trip	$118	350%
Usa Managed Care Organization	$118	350%
Multiplan/Phcs	$126	374%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $158.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97750.

Insurance In-Network Protection Plan

Contact your insurance company to confirm PAM Rehabilitation Hospital of Dayton LLC is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97750.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.