CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Prisma Health Baptist

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $47
Cash Discount Price: $80
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Prisma Health Baptist is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.39x the Medicare baseline. Located in 1330 Taylor at Marion St, Columbia, SC.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $80 (237%)

Insurance Median: $47 (139%)

Cash: $80 (237% of Medicare)

Ins. Median: $47 (139% 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
Medicaid / KanCare	$19 - $90	56%
UnitedHealthcare	$19 - $34	56%
Prisma Health Seniorcare Pace - Midlands [5400]	$29	86%
Prisma Health Seniorcare Pace-Upstate [5200]	$29	86%
Blue Cross Blue Shield	$32 - $94	95%
Cigna	$32 - $188	95%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904]	$32	95%
Humana	$32 - $92	95%
Medicare (plans)	$32 - $34	95%
Tricare	$32	95%
Triwest Healthcare Alliance Vcp [902]	$32	95%
Va Community Care Network-Vaccn [903]	$32	95%
Aetna	$34 - $97	101%
Golden Rule Insurance Company [2991]	$34	101%
Healthy Conn Prime-First Choice Vip Care [5300]	$34	101%
Healthy Conn Prime-Molina Healthcare [5330]	$34	101%
Healthy Conn Prime-Wellcare Prime By Atc [5310]	$34	101%
Oxford Health Plans [2992]	$34	101%
Zzumr-Salt Lake City Ut [3169]	$34	101%
Scdc-Sc Dept Of Corrections [7232]	$37	110%
Promise Health Plan Contracted [2401]	$43 - $74	127%
Workers Comp [600]	$45	133%
Orangeburg Senior Helping Center Pace [5401]	$49	145%
Ambetter / Centene	$59	175%
Bluechoice [810]	$62 - $94	184%
Bob Jones Univ-Pai [821]	$74	219%
Meritain Health Contracted [2200]	$79 - $97	234%
Preferred Administrators Contracted [2839]	$86	255%
Medcost [2940]	$91 - $102	270%
Atlantic Packaging Contracted [4833]	$92	273%
Planned Administrators [820]	$94	279%
Nippon [2300]	$97	288%
Aps Healthcare System [2981]	$98	291%
Multiplan/Phcs Contracted [2950]	$109	323%
Vsp Vision Care [2986]	$111	329%
First Health Contracted [2952]	$114	338%
Furman Int/Allen University Student [2951]	$114	338%
Quiktrip-First Health [3067]	$114	338%
Evernorth Behavioral Contracted [2982]	$188	557%

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 $80.
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 Prisma Health Baptist 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.