CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Uva Health Culpeper Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $46
Cash Discount Price: $45
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Uva Health Culpeper Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.36x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $45 (133%)

Insurance Median: $46 (136%)

Cash: $45 (133% of Medicare)

Ins. Median: $46 (136% 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.

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	$15 - $79	44%
Cigna	$21 - $360	62%
Multiplan Generic [40035]	$24 - $76	71%
Vhn Generic [40040]	$24 - $76	71%
Sentara Behavioral Health [40052]	$25 - $166	74%
Sentara [40021]	$25 - $166	74%
Kaiser Permenente [40014]	$29 - $81	86%
Blue Ridge Pace [10510]	$30	89%
Medicaid / KanCare	$30	89%
Veterans [99909]	$32	95%
Blue Cross Blue Shield	$33	98%
HMO Part B [10099]	$33	98%
Humana	$33 - $34	98%
Medicare (plans)	$33	98%
UnitedHealthcare	$33 - $282	98%
VA Ccn [99926]	$33	98%
VA Ccn [99927]	$33	98%
Veterans Administration [99910]	$33	98%
Champva [50002]	$34	101%
Tricare	$34	101%
Beacon Health Options [40012]	$45	133%
Commercial Contracted Hb Only [40056]	$47	139%
Commercial Generic [40000]	$47 - $63	139%
Geha [40009]	$52 - $228	154%
Commercial Contracted Tpa [40055]	$54 - $63	160%
Umwa [40037]	$63	187%
Healthsmart [40013]	$68	202%
First Health Generic [40033]	$74	219%
Gateway Health Alliance [40034]	$76	225%
Onenet Workers Comp Generic [60010]	$79	234%
Carefirst [30007]	$91 - $97	270%

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 $45.
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 Uva Health Culpeper Medical Center 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.