CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Intermountain Health Delta Community Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $117
Cash Discount Price: $92
vs. Medicare Baseline: 3.47x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Intermountain Health Delta Community Hospital is $117. 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 3.47x the Medicare baseline. Located in 126 South White Sage Avenue, Delta, UT.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $117 (347%)

Cash: $92 (273% of Medicare)

Ins. Median: $117 (347% 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 347% of the Medicare baseline (a markup of 247%). 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
Aetna	$33 - $118	98%
American Health	$33 - $39	98%
Blue Cross Blue Shield	$33 - $117	98%
Health Partners Of Nevada	$33 - $39	98%
Health Plan Of Nevada	$33 - $110	98%
Healthy U	$33 - $110	98%
Humana	$33 - $39	98%
Molina	$33 - $117	98%
Selecthealth	$33 - $117	98%
UnitedHealthcare	$33 - $117	98%
Triwest	$47	139%
Injury Care Of Nevada	$92	273%
Byu Risk Management	$105	311%
Corporation Of The President	$105	311%
Corvel Corporation	$105	311%
Wcf Insurance	$105	311%
Awh Connected	$117 - $118	347%
Byu Athletics	$117	347%
Campbell Scientific	$117	347%
Cigna	$117	347%
Deseret Mutual	$117	347%
Emi	$117	347%
Emi Health	$117	347%
Franklin County	$117	347%
Global Excel	$117	347%
Health Utah	$117	347%
Hygeia Corporation	$117	347%
Ifit	$117	347%
Juniper Systems	$117	347%
Lw Miller	$117	347%
Managed Care Admin	$117	347%
Medcare International	$117	347%
Motivhealth	$117	347%
Pehp	$117	347%
Prodegi Corp Benefit	$117	347%
Springtide	$117	347%
Tanner Llc	$117	347%
Uofu	$117	347%
Utah Tech	$117	347%
Wise Network	$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 Intermountain Health Delta Community 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.