CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Geisinger-Lewistown Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $68
Cash Discount Price: $86
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Geisinger-Lewistown Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.02x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $86 (255%)

Insurance Median: $68 (202%)

Cash: $86 (255% of Medicare)

Ins. Median: $68 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Medicaid / KanCare	$17	50%
Amerihealth	$18	53%
Geisinger Family Plan	$18	53%
Health Partners	$20	59%
Upmc Health Plan	$20 - $11,890	59%
Upmc Chip	$21	62%
Blue Cross Blue Shield	$46 - $75	136%
Aetna	$57 - $68	169%
Cigna	$60 - $73	178%
UnitedHealthcare	$62	184%
Christian Healthcare Ministries	$70	208%
Christian Health Aid	$111	329%
Three Rivers Provider Network Inc.	$111	329%
Multiplan	$118	350%
Healthsmart Payors Organization	$125	371%

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 $86.
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 Geisinger-Lewistown Hospital 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.