CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Baptist Memorial Hospital Tipton

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $120
Cash Discount Price: $48
vs. Medicare Baseline: 3.56x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Baptist Memorial Hospital Tipton is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.56x the Medicare baseline. Located in 1995 Highway 51 S, Covington, TN.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $48 (142%)

Insurance Median: $120 (356%)

Cash: $48 (142% of Medicare)

Ins. Median: $120 (356% 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 356% of the Medicare baseline (a markup of 256%). 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
Magnolia Tn	$15	44%
Aetna	$22 - $60	65%
Blue Cross Blue Shield	$34 - $120	101%
Humana	$67	199%
Ppo Holdings	$76	225%
Magnolia Regional Health Center	$80	237%
Multiplan	$86 - $150	255%
Littler	$100	296%
Molina	$100	296%
Access Health Services	$120	356%
Butler Snow	$120	356%
UnitedHealthcare	$120	356%
Oscar	$130	385%
First Choice Health Plan Of Ms	$140	415%
Mpcn	$150	445%
Novasys	$150	445%
Ppo Plus	$170	504%
Qca	$180	534%
Cigna	$185 - $204	548%

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 $48.
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 Baptist Memorial Hospital Tipton 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.