CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Shriners Hospitals for Children

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $45
Cash Discount Price: $453
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Shriners Hospitals for Children is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $453. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.33x the Medicare baseline. Located in 950 West Faris Road, Greenville, SC.

Cash / Self-Pay

$453

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $453 (1343%)

Insurance Median: $45 (133%)

Cash: $453 (1343% of Medicare)

Ins. Median: $45 (133% 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
Amerihealth Mercy Health Plans	$17	50%
Aetna	$32	95%
Ambetter / Centene	$32 - $49	95%
Amerihealth Caritas Nc	$37	110%
Amerihealth Caritas Sc	$37	110%
Blue Cross Blue Shield	$45 - $53	133%
Sana Benefits	$45	133%
Humana	$49	145%
Molina Healthcare Of Sc	$49	145%
Select Health Of Sc	$49	145%
Cigna	$130	385%
Providence Health Plan	$139	412%

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 $453.
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 Shriners Hospitals for Children 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.