CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Lds Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $109
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 3.23x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Lds Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.23x the Medicare baseline. Located in 8Th Avenue and C Street, Salt Lake City, UT.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $116 (344%)
Insurance Median: $109 (323%)
Cash: $116 (344% of Medicare)
Ins. Median: $109 (323% 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 323% of the Medicare baseline (a markup of 223%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $33 - $133 98%
American Health $33 98%
Blue Cross Blue Shield $33 - $119 98%
Health Partners Of Nevada $33 98%
Health Plan Of Nevada $33 - $47 98%
Healthy U $33 98%
Humana $33 - $34 98%
Molina $33 - $128 98%
Selecthealth $33 - $90 98%
Southwest Behavioral Health $33 98%
Triwest $33 98%
UnitedHealthcare $33 - $133 98%
Donor Connect $40 119%
Intermountain Caregiver Plan $65 - $86 193%
Emi $83 - $84 246%
Deseret Mutual $89 - $90 264%
Cigna $97 - $133 288%
Awh Connected $98 - $101 291%
Emi Health $107 - $108 317%
Pehp $107 - $139 317%
Byu Risk Management $108 - $114 320%
Corporation Of The President $108 - $114 320%
Wcf Insurance $108 - $114 320%
Byu Athletics $111 - $112 329%
Campbell Scientific $111 - $112 329%
Corvel Corporation $111 - $112 329%
Franklin County $111 - $112 329%
Ifit $111 - $112 329%
Juniper Systems $111 - $112 329%
Lw Miller $111 - $112 329%
Managed Care Admin $111 - $122 329%
Tanner Llc $111 - $112 329%
Utah Tech $111 - $112 329%
Injury Care Of Nevada $116 - $117 344%
Prodegi Corp Benefit $126 - $128 374%
Uofu $126 - $128 374%
Springtide $128 - $130 379%
Altius Mhnet Behavioral Health $131 - $133 388%
First Choice $131 - $133 388%
Global Excel $131 - $133 388%
Medcare International $131 - $133 388%
Motivhealth $131 - $133 388%
Utah Behavioral Health Network $131 - $133 388%
Wise Network $131 - $133 388%
Hygeia Corporation $139 - $140 412%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8Th Avenue and C Street, Salt Lake City, UT 84143
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals