CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Aurora Medical Center Bay Area

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $275
Cash Discount Price: $88
vs. Medicare Baseline: 8.15x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Aurora Medical Center Bay Area is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 8.15x the Medicare baseline. Located in 3003 University Dr, Marinette, WI.

Cash / Self-Pay

$88

Average discount available for prompt cash payment at this facility.

Insurance Median

$275

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: $88 (261%)

Insurance Median: $275 (815%)

Cash: $88 (261% of Medicare)

Ins. Median: $275 (815% 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 815% of the Medicare baseline (a markup of 715%). 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 Eos Plus	$105	311%
Blue Cross Blue Shield	$122 - $291	362%
Healthpartners	$131 - $360	388%
Health Eos	$140	415%
Aetna	$145 - $222	430%
UnitedHealthcare	$147 - $302	436%
Cigna	$148 - $320	439%
Everpointe Elite	$259	768%
Aurora Caregiver	$260	771%
Molina Exchange	$266	789%
Quartz One	$270	800%
Centivo	$274	812%
Common Ground	$281	833%
Hs Technology	$304	901%
Quartz Group	$320	949%
Health Payment Systems	$325	964%
Trilogy	$328	972%
Wisconsin Physician Service	$359 - $378	1064%

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 $88.
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 Aurora Medical Center Bay Area 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.