Physical therapy (functional capacity test)
Facility: Shirley Ryan Abilitylab
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $182
- Cash Discount Price: $182
- vs. Medicare Baseline: 5.40x 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 540% of the Medicare baseline (a markup of 440%). 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 |
|---|---|---|
| Aetna | $34 - $162 | 101% |
| Humana | $34 | 101% |
| Advocate Health Partners | $34 - $303 | 101% |
| Tricare | $34 | 101% |
| Health Care Services Corporation | $34 - $145 | 101% |
| Wellcare Meridian Fide | $34 | 101% |
| UnitedHealthcare | $34 - $135 | 101% |
| Meridian Health Plan | $76 | 225% |
| Blue Cross Blue Shield | $76 - $141 | 225% |
| County Care | $76 | 225% |
| Hfn | $83 - $273 | 246% |
| Multiplan | $86 | 255% |
| Coventry Workers Comp | $86 | 255% |
| Corvel Corporation | $86 | 255% |
| Personalcare Insurance of Il/Firsthealth Grp Corp/Coventryhealth and Life Insurance Co | $87 - $258 | 258% |
| Paradigm Health Corporation | $87 - $170 | 258% |
| State of Illinois | $87 - $161 | 258% |
| Uic Physician Group-Campuscare | $152 - $167 | 451% |
| Uic Physician Group | $167 - $245 | 495% |
| Endeavor Health Sites 243/447 Northshore and Edwards | $167 | 495% |
| Union Health Service | $170 | 504% |
| Cigna | $171 - $186 | 507% |
| Affordable Health Care Concepts | $182 | 540% |
| University of Chicago Practice Plan | $182 - $197 | 540% |
| Loyola University Physician Foundation | $197 | 584% |
| Health Care Services Corporation DBA Managed Care Network Preferred | $206 - $270 | 611% |
| Advocate and Advocate Health Partners | $212 | 629% |
| Gallagher Benefit Administrators | $227 | 673% |
| Resurrection Health Care Preferred | $227 - $242 | 673% |
| Health Care Services Corporation D/B/A HMO Illinois | $236 | 700% |
| Unicare Life and Health Insurance | $236 | 700% |
| Private Healthcare Systems | $242 | 717% |
| Health Payors Organization | $258 | 765% |
| Cofinity Aka Ppom | $258 | 765% |
| Healthnetwork | $267 - $288 | 792% |