CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Gundersen Lutheran Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $132
Cash Discount Price: $100
vs. Medicare Baseline: 3.91x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Gundersen Lutheran Medical Center is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.91x the Medicare baseline. Located in 1910 South Ave, La Crosse, WI.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$132

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: $100 (296%)

Insurance Median: $132 (391%)

Cash: $100 (296% of Medicare)

Ins. Median: $132 (391% 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 391% of the Medicare baseline (a markup of 291%). 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
Amerigroup	$15 - $43	44%
Blue Cross Blue Shield	$15 - $486	44%
Group Health Eau Claire	$15 - $338	44%
Group Health Of South Central	$15 - $300	44%
Icare	$15 - $43	44%
Iowa Total Care	$15	44%
Managed Health Service	$15	44%
Molina Health	$15	44%
UnitedHealthcare	$15 - $306	44%
Aetna	$43 - $356	127%
Medical Associates	$43 - $281	127%
Ucare	$43 - $300	127%
Medica	$52 - $287	154%
Dean Health Plan	$65 - $157	193%
Quartz	$66 - $159	196%
Health Partners	$78 - $331	231%
Midland Choice	$116 - $281	344%
Alliance	$122 - $315	362%
Claim Doc Llc	$124 - $300	368%
Wps Narrow Network	$126 - $304	374%
Cigna	$127 - $308	377%
Wps - Arise	$127 - $308	377%
Aspirus Arise Health	$129 - $311	382%
Allied National General	$132 - $319	391%
Preferred One	$132 - $319	391%
Wps Statewide	$132 - $318	391%
Coventry Health Care	$147 - $356	436%
Humana	$147 - $356	436%
Multiplan/Healtheos	$149 - $360	442%

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 $100.
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 Gundersen Lutheran 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.