CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Lafollette Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $30
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Lafollette Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 0.89x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $25 (74%)
Insurance Median: $30 (89%)
Cash: $25 (74% of Medicare)
Ins. Median: $30 (89% 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.

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
Humana $4 - $35 12%
Aetna $5 - $100 15%
Medicaid / KanCare $5 - $48 15%
Self Pay $5 - $46 15%
UnitedHealthcare $5 - $306 15%
Wellcare $5 - $40 15%
Multiplan Complementary $14 - $123 42%
Tricare $15 - $30 44%
Blue Cross Blue Shield $18 - $142 53%
Medicare (plans) $18 - $31 53%
Node Bluecare Plus Tn Mcr Adv $18 - $31 53%
Triwest $18 - $31 53%
Amerigroup $19 - $31 56%
Bluecare $19 - $28 56%
Node Amerigroup Mcr Adv $19 - $33 56%
Node Blueadvantage Mcr Adv $19 - $32 56%
Node Champva $19 - $31 56%
Node Devoted Health Mcr Adv $19 - $32 56%
Node Farm Bureau Mcr Adv $19 - $32 56%
Node Healthspring Mcr Adv $19 - $32 56%
Node Hospice Non Par Agree $19 - $32 56%
Node Va $19 - $32 56%
Node Wellcare Mcr Adv $19 - $32 56%
Novanet Work Comp Tn $19 - $46 56%
Tn Work Comp $19 - $47 56%
Veterans Eval Services $19 - $31 56%
Windsor Health Plan $19 - $33 56%
Node Nhc Mcr Adv $20 - $35 59%
Node Us Dept Of Labor $23 - $49 68%
Ambetter / Centene $35 - $59 104%
Node Point Comfort Underwriters $41 - $70 122%
Cigna $134 397%
Beech Street Work Comp Tn $1,856 - $4,739 5503%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals