CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: University Health System, Inc

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $79
Cash Discount Price: $33
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at University Health System, Inc is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.34x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $33 (98%)

Insurance Median: $79 (234%)

Cash: $33 (98% of Medicare)

Ins. Median: $79 (234% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 234% of the Medicare baseline (a markup of 134%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$25 - $92	74%
Blue Cross Blue Shield	$29 - $126	86%
Cigna	$31 - $100	92%
Humana	$31	92%
Aetna	$32 - $92	95%
Devoted Health	$32	95%
American Health	$33	98%
Medicare (plans)	$33	98%
Nhc	$33	98%
Wellcare-Windsor Medadv	$33	98%
Wellpoint	$33 - $37	98%
Fentress County Sheriffs Dept	$53	157%
Multiplan	$79	234%
Nx Health	$79	234%
Phcs	$79	234%
Naphcare	$85 - $86	252%
Coventry	$92	273%
Beechstreet	$99	294%
Prime Health	$99 - $132	294%
Seven Corners	$99	294%
Usa	$105 - $106	311%
Evolutions	$118 - $119	350%
Galaxy	$118 - $119	350%
Healthsmart	$118 - $119	350%

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 $33.
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 University Health System, Inc 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.