Physical therapy (functional capacity test)
Facility: Lancaster General Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $85
- Cash Discount Price: $100
- vs. Medicare Baseline: 2.52x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 252% of the Medicare baseline (a markup of 152%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Hospice And Community Care | $18 - $26 | 53% |
| UnitedHealthcare | $18 - $116 | 53% |
| Medicaid / KanCare | $23 - $62 | 68% |
| Upmc For You | $24 - $34 | 71% |
| Old Order Group | $26 - $44 | 77% |
| Lg Coresource/Lg Eliance | $27 - $39 | 80% |
| Lancashire Hall | $29 - $136 | 86% |
| Nursing Home Op Services | $29 - $41 | 86% |
| Tricare | $29 | 86% |
| Aetna | $32 - $92 | 95% |
| Albright Life | $32 | 95% |
| Blue Cross Blue Shield | $32 - $405 | 95% |
| Coatesville Va | $32 | 95% |
| Highmark | $32 - $136 | 95% |
| Hospice Generic | $32 | 95% |
| Lebanon Veterans Hospital | $32 | 95% |
| Medicare (plans) | $32 - $35 | 95% |
| Amerihealth Caritas | $33 | 98% |
| Cigna | $33 - $114 | 98% |
| Health Partners Mcr Advantage | $33 | 98% |
| Devoted Health | $34 | 101% |
| Pa Health And Wellness Mcr | $34 | 101% |
| Affilia Home Health | $38 - $136 | 113% |
| Masonic Homes | $40 - $136 | 119% |
| Elap Employees | $45 | 133% |
| Gateway | $48 - $68 | 142% |
| Eliance Health Solutions | $61 - $87 | 181% |
| Oscar Health Plan | $62 | 184% |
| Highmark Commercial Preferred | $64 - $136 | 190% |
| Ehp | $79 - $112 | 234% |
| Upmc Commercial | $79 - $116 | 234% |
| Devon | $82 - $116 | 243% |
| Geisinger Commercial | $82 - $116 | 243% |
| Intergroup Services | $82 - $116 | 243% |
| Preferred Healthcare | $82 - $116 | 243% |
| Medi-Share Christian Care | $91 - $129 | 270% |
| Claim Watcher Plus | $96 | 285% |
| Commercial Generic | $96 - $136 | 285% |
| Highmark Commercial Non-Preferred | $96 - $137 | 285% |
| Magellan | $96 - $136 | 285% |
| United Behavioral Health | $96 - $136 | 285% |
| Value Options | $96 - $136 | 285% |
| Workers Compensation | $96 - $136 | 285% |
| Claim Watcher | $105 | 311% |
| Elap Other Groups | $116 | 344% |
| Gift Of Life Donor Program | $13,500 | 40024% |