CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Cedar City Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $111
Cash Discount Price: $92
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Cedar City Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.29x the Medicare baseline. Located in 1303 North Main Street, Cedar City, UT.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $92 (273%)

Insurance Median: $111 (329%)

Cash: $92 (273% of Medicare)

Ins. Median: $111 (329% 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 329% of the Medicare baseline (a markup of 229%). 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
Health Choice	$27 - $110	80%
Health Plan Of Nevada	$27 - $110	80%
Healthy U	$27 - $110	80%
Molina	$27 - $117	80%
Selecthealth	$27 - $111	80%
Aetna	$33 - $119	98%
American Health	$33 - $34	98%
Blue Cross Blue Shield	$33 - $117	98%
Health Partners Of Nevada	$33	98%
Humana	$33 - $34	98%
Southwest Behavioral Health	$33	98%
Triwest	$33	98%
UnitedHealthcare	$33 - $111	98%
Corporation Of The President	$92	273%
Corvel Corporation	$92	273%
Injury Care Of Nevada	$92	273%
Wcf Insurance	$92	273%
Byu Risk Management	$105	311%
Awh Connected	$111 - $112	329%
Byu Athletic Department	$111	329%
Campbell Scientific	$111	329%
Deseret Mutual	$111	329%
Emi	$111	329%
Emi Health	$111	329%
Franklin County	$111	329%
Global Excel	$111	329%
Ifit	$111	329%
Juniper Systems	$111	329%
Lw Miller	$111	329%
Managed Care Admin	$111	329%
Medcare International	$111	329%
Motivhealth	$111	329%
Pehp	$111 - $117	329%
Prodegi Corp Benefit	$111	329%
Tanner Llc	$111	329%
Uofu	$111 - $117	329%
Utah Tech	$111	329%
Wise Network	$111	329%
Cigna	$117	347%
Health Utah	$117	347%
Hygeia Corporation	$117	347%
Springtide	$117	347%

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 $92.
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 Cedar City 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.