CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Erlanger Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $44
Cash Discount Price: $37
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Erlanger Medical Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.30x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $37 (110%)

Insurance Median: $44 (130%)

Cash: $37 (110% of Medicare)

Ins. Median: $44 (130% 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
Amerigroup	$21 - $95	62%
Caresource	$21 - $85	62%
Peach State Hlth Plan	$21	62%
Bluecare	$22 - $103	65%
Blue Cross Blue Shield	$25 - $75	74%
Aetna	$28 - $44	83%
UnitedHealthcare	$28 - $57	83%
Humana	$31 - $61	92%
Cigna	$32 - $200	95%
Alexian	$43 - $44	127%
Clover	$43 - $44	127%
Upmc	$43 - $44	127%
American Health	$44 - $45	130%
Devoted Health	$44 - $45	130%
Medicare (plans)	$44	130%
Nhc	$45 - $46	133%
Pruitthealth Premier	$45	133%
Atrio Health	$47 - $48	139%
Simpra Advantage	$48	142%
Ambetter / Centene	$53 - $54	157%
Caresource Ga	$62 - $111	184%
Caresource Tn	$62 - $111	184%
Olympus	$65 - $74	193%
Alliant	$70	208%
Pnoa	$70 - $107	208%
Caresource Nc	$75 - $111	222%
Occunet	$76	225%
Point Comfort Underwriters	$77 - $78	228%

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 $37.
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 Erlanger Medical Center 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.