CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Hillsboro Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $39
Cash Discount Price: $146
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Hillsboro Medical Center is $39. 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 1.16x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $39 (116%)

Cash: $146 (433% of Medicare)

Ins. Median: $39 (116% 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
Care Oregon	$28 - $42	83%
Intercommunity Health Network	$28	83%
Medicare (plans)	$28 - $42	83%
Kaiser Foundation Hospitals	$29 - $105	86%
Pacific Source	$29 - $144	86%
Community Health Plan Of Washington	$36 - $225	107%
Providence Health Plan	$36 - $225	107%
Samaritan Health Plan	$36	107%
Trillium	$36	107%
Humana	$37 - $38	110%
UnitedHealthcare	$38 - $57	113%
Aetna	$39 - $202	116%
Moda	$40 - $129	119%
Health Net Health Plan Of Oregon, Inc.	$41 - $148	122%
Blue Cross Blue Shield	$111	329%
Tuality Health	$146	433%
First Choice	$180	534%
Coventry First Health	$191	566%
Cigna	$225	667%
Molina Exchange	$225	667%

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 Hillsboro Medical Center 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.