CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: St Jude Childrens Research Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $73
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at St Jude Childrens Research Hospital is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.16x the Medicare baseline. Located in 262 Danny Thomas Place, Memphis, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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%)

Insurance Median: $73 (216%)

Ins. Median: $73 (216% 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 216% of the Medicare baseline (a markup of 116%). 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
Healthcare Connections La	$17	50%
UnitedHealthcare	$22 - $110	65%
Blue Cross Blue Shield	$24 - $103	71%
Tenncare Select Hmo	$26	77%
Empower	$27	80%
Healthy Blue	$28	83%
Home State Health	$29 - $82	86%
Medicaid / KanCare	$30	89%
Molina Marketplace Of Ms	$44	130%
Health Choice - Ok	$66	196%
Vantage	$66 - $74	196%
Humana	$72	213%
Tricare	$77	228%
Aetna	$82	243%
Private Health Care Systems	$88	261%
Ms Physicians Care Network	$94	279%
Baptist Health	$99	294%
First Health Ccn	$99	294%
Health Choice	$99	294%
Health Link Mississippi	$99	294%
Healthscope Benefits Inc	$99	294%
Cigna	$160	474%

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 $X.
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 St Jude Childrens Research Hospital 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.