CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Cleveland Clinic Children's Hospital for Rehab

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $135
Cash Discount Price: $146
vs. Medicare Baseline: 4.00x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Cleveland Clinic Children's Hospital for Rehab is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 4.00x the Medicare baseline. Located in 2801 Martin Luther King, Jr Drive, Cleveland, OH.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$135

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: $146 (433%)

Insurance Median: $135 (400%)

Cash: $146 (433% of Medicare)

Ins. Median: $135 (400% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 400% of the Medicare baseline (a markup of 300%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Oscar	$68 - $87	202%
Aultcare	$76	225%
Aetna	$80 - $225	237%
Cigna	$97 - $180	288%
Amish Community Aid Plan	$101 - $112	299%
Ohcp	$109	323%
Summacare	$112 - $113	332%
UnitedHealthcare	$117 - $165	347%
Buckeye	$123 - $149	365%
Healthsmart	$124	368%
Paramount	$127	377%
United	$129 - $132	382%
Blue Cross Blue Shield	$130 - $170	385%
Molina	$130	385%
Caresource	$132	391%
Php	$135	400%
Phphi	$135	400%
The Health Plan	$135	400%
Upmc	$135	400%
Amerihealth	$136	403%
Gms	$158	468%
Medical Benefit Corp	$158	468%
Quality Care Partners	$158	468%
Cc Ehp	$160	474%
Consociate Health	$169	501%
Ohio Healthy	$180	534%
Managed Care Services	$202	599%
Multiplan	$202	599%
Three Rivers	$202	599%

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 $146.
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 Cleveland Clinic Children's Hospital for Rehab 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.