Physical therapy (functional capacity test)
Facility: Lindsborg Community Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $97
- Cash Discount Price: $76
- vs. Medicare Baseline: 2.88x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 288% of the Medicare baseline (a markup of 188%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $45 - $96 | 133% |
| Coventry Mcr Adv | $46 - $97 | 136% |
| Blue Cross Blue Shield | $53 | 157% |
| Cigna | $82 - $173 | 243% |
| UnitedHealthcare | $87 - $184 | 258% |
| Coventry Comm-All Other Plans | $87 - $184 | 258% |
| Phcs Preferred-All Plans | $90 - $190 | 267% |
| Multiplan-All Plans | $90 - $190 | 267% |
| Health Partners -All Plans | $91 - $194 | 270% |
| Century Health-All Plans | $91 - $194 | 270% |
| Coventry Wc | $91 - $194 | 270% |
| Wppa-All Plans | $91 - $194 | 270% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) service at Lindsborg Community Hospital, the cash price is $76.00, which is lower than the facility's negotiated rates of $97.00 and the Medicare benchmark of $33.73. While the cash rate is significantly higher than the Medicare amount, patients with high-deductible plans may find paying out-of-pocket cheaper than using insurance, as the negotiated rate of $97.00 often exceeds the cash price. To maximize savings, patients should verify if their specific insurance plan has a deductible that has already been met, as paying the full negotiated rate before meeting that threshold can result in higher out-of-pocket costs than the cash option.
The facility offers a cash price of $76.00, which is notably lower than the median negotiated rate of $97.00 across the 12 payer plans listed. Although the data does not provide specific county or state average comparisons for this procedure, the significant difference between the cash rate and the negotiated rates highlights the potential for savings through prompt-pay discounts. Patients are encouraged to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final bill by bypassing the administrative costs associated with insurance claims processing.