CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Excela Health - Frick Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $35
Cash Discount Price: $58
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Excela Health - Frick Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 508 South Church Street, Mount Pleasant, PA.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $58 (172%)

Insurance Median: $35 (104%)

Cash: $58 (172% of Medicare)

Ins. Median: $35 (104% 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
Upmc For Kids Chip	$12	36%
Highmark Advantage Community Blue	$30	89%
Va	$32	95%
Aetna	$33 - $73	98%
Health Partners Plan	$33	98%
Humana	$33	98%
Martin'S Point	$33	98%
Peak Health	$33 - $75	98%
United	$33	98%
Amerihealth Caritas	$34	101%
Cigna	$34 - $80	101%
Devoted	$34	101%
Geisinger	$34	101%
Pa Health And Wellness	$34	101%
The Health Plan Of West Virginia	$34 - $75	101%
American Health Plan Of Pa	$35	104%
Highmark Wholecare	$35	104%
Provider Network Of America	$35 - $77	104%
Provider Plan Partners Plan	$35	104%
UnitedHealthcare	$35	104%
Upmc	$35	104%
Upmc Health Plan	$37 - $53	110%
Highmark Children'S Health Insurance Program	$38	113%
Ambetter / Centene	$40	119%
Highmark	$43 - $70	127%
Velocity	$48	142%
Community Blue	$63	187%

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 $58.
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 Excela Health - Frick 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.