CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Mercy Hospital Marietta

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $79
Cash Discount Price: $131
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Mercy Hospital Marietta is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.34x the Medicare baseline. Located in 300 Wanda Street, Marietta, OK.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $131 (388%)

Insurance Median: $79 (234%)

Cash: $131 (388% of Medicare)

Ins. Median: $79 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Aetna	$42 - $91	125%
Blue Cross Blue Shield	$42 - $64	125%
Cross Timbers Hospice [20098]	$42	125%
Elara Caring Aspire Hospice Contracted [320433]	$42	125%
Elara Caring Aspire Hospice [20433]	$42	125%
Halo Hcr Inc Hospice Contracted [320432]	$42	125%
Halo Hcr Inc Hospice [20432]	$42	125%
Humana	$42	125%
Independent Health [20197]	$42	125%
Indian Health Service Contracted [320198]	$42	125%
Kindful Hospice Contracted [320434]	$42	125%
Kindful Hospice [20434]	$42	125%
Medical Associates Health [20444]	$42	125%
Medicare (plans)	$42 - $45	125%
Mercy Hospice Okc [20252]	$42	125%
Tricare	$45	133%
UnitedHealthcare	$45 - $92	133%
Cigna	$46 - $98	136%
Webtpa Contracted [320417]	$55	163%
Aither Health Contracted [320449]	$79 - $111	234%
Mercy Benefit Admin Contracted [320251]	$79 - $118	234%
Quik Trip Contracted [320447]	$79	234%
Show-Me Health Administrators Contracted [320483]	$79	234%
Osma Health Contracted [320292]	$92	273%
United Medical Resources Contracted [320454]	$92 - $118	273%
First Health Contracted [320128]	$93	276%
Benefit Management Contracted [320052]	$98 - $118	291%
Healthcare Highways Plus Contracted [320175]	$98	291%
Auxiant Contracted [320462]	$111 - $118	329%
Ebms Contracted [320493]	$111	329%
Healthlink Contracted [320179]	$111 - $118	329%
Preferred Community Choice Contracted [320311]	$111	329%
Federal Medical Center Contracted [320127]	$118	350%
Healthscope Contracted [320182]	$118	350%
Point C Contracted [320238]	$118	350%
Preferred Health Plan Contracted [320522]	$118	350%
Tri State Healthcare Coalition Contracted [320379]	$118	350%

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 $131.
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 Mercy Hospital Marietta 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.