CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Snoqualmie Valley Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $90
Cash Discount Price: $113
vs. Medicare Baseline: 2.67x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Snoqualmie Valley Hospital is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.67x the Medicare baseline. Located in 9801 Frontier Ave Se, Snoqualmie, WA.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $113 (335%)

Insurance Median: $90 (267%)

Cash: $113 (335% of Medicare)

Ins. Median: $90 (267% 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 267% of the Medicare baseline (a markup of 167%). 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	$82 - $114	243%
Amerigroup Wellpoint	$82 - $97	243%
Blue Shield Of Wa Regence Mcr Adv	$82 - $84	243%
Community Health Plan Of Wa	$82 - $85	243%
Humana	$82 - $84	243%
Medicare (plans)	$82 - $83	243%
Molina Healthcare Of Washington Mcr Adv	$82 - $83	243%
Molina Healthcare Of Washington	$83 - $85	246%
UnitedHealthcare	$83 - $181	246%
Washington Coordinated Care	$83 - $99	246%
Community Health Plan Of Wa Mcd Rep	$90 - $92	267%
Medicaid / KanCare	$90 - $92	267%
Molina Healthcare Of Washington Mcd Rep	$98 - $99	291%
Blue Cross Blue Shield	$116 - $118	344%
Blue Shield Of Wa Regence	$116 - $118	344%
Kaiser Foundation Health Plan Of The Northwest	$122 - $124	362%
First Choice Health Network	$135 - $138	400%
Cigna	$155 - $157	460%

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 $113.
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 Snoqualmie Valley 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.