CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Excela Health Latrobe Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $33
Cash Discount Price: $74
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Excela Health Latrobe Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 0.98x the Medicare baseline. Located in One Mellon Way, Latrobe, PA.

Cash / Self-Pay

$74

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $74 (219%)

Insurance Median: $33 (98%)

Cash: $74 (219% of Medicare)

Ins. Median: $33 (98% 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
Highmark Advantage Community Blue	$12 - $30	36%
Upmc For Kids Chip	$12	36%
Amerihealth Caritas	$13 - $34	39%
Cigna	$13 - $80	39%
Devoted	$13 - $34	39%
Geisinger	$13 - $34	39%
Health Partners Plan	$13 - $33	39%
Humana	$13 - $33	39%
Martin'S Point	$13 - $33	39%
Peak Health	$13 - $75	39%
United	$13 - $33	39%
Va	$13 - $32	39%
American Health Plan Of Pa	$14 - $35	42%
Highmark Wholecare	$14 - $35	42%
Pa Health And Wellness	$14 - $34	42%
Provider Network Of America	$14 - $120	42%
Provider Plan Partners Plan	$14 - $35	42%
The Health Plan Of West Virginia	$14 - $75	42%
UnitedHealthcare	$14 - $35	42%
Upmc	$14 - $35	42%
Highmark Children'S Health Insurance Program	$15 - $38	44%
Upmc Health Plan	$15 - $53	44%
Ambetter / Centene	$16 - $40	47%
Highmark	$17 - $70	50%
Velocity	$19 - $48	56%
Community Blue	$25 - $63	74%
Aetna	$33 - $73	98%

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 $74.
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 Latrobe 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.