CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Charleston Area Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $36
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Charleston Area Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $202 (599%)
Insurance Median: $36 (107%)
Cash: $202 (599% of Medicare)
Ins. Median: $36 (107% 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.

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
Triwest Va $22 - $31 65%
Aetna $23 - $306 68%
Blue Cross Blue Shield $23 - $285 68%
Choicecare Network $23 - $306 68%
The Health Plan Of West Virginia Inc. $23 - $303 68%
Unicare Health Plan Of West Virginia Inc. $23 - $26 68%
UnitedHealthcare $23 - $306 68%
West Virginia Senior Advantage Inc. $24 - $33 71%
City Of Charleston $30 - $234 89%
Naphcare $31 - $63 92%
Integrated Medical Solutions $33 - $61 98%
Optimum Choice Inc. $33 - $36 98%
Caresource $34 - $79 101%
Tricare $55 - $187 163%
Three Rivers Providers Network $88 - $303 261%
Healthsmart $89 - $306 264%
Multiplan $89 - $306 264%
Cigna $90 - $290 267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Morris Street, Charleston, WV 25301
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals