Physical therapy (functional capacity test)
Facility: Hackensack Meridian Mountainside Medical
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $144
- Cash Discount Price: $46
- vs. Medicare Baseline: 4.27x 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 427% of the Medicare baseline (a markup of 327%). 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 |
|---|---|---|
| Healthscope Benefits [2290] | $18 - $144 | 53% |
| UnitedHealthcare | $18 | 53% |
| Aetna | $26 - $148 | 77% |
| Web Tpa [2115] | $69 - $148 | 205% |
| Create Flex / Select [3580] | $69 | 205% |
| Oncology Patient Assistance Programs [2295] | $69 | 205% |
| Black Lung [6055] | $69 | 205% |
| Lucent Health [6000] | $69 | 205% |
| Wtc Healthcare Sme Karna [8005] | $69 | 205% |
| Medicare (plans) | $69 | 205% |
| Selecthealth [3740] | $69 | 205% |
| Worker's Comp [2125] | $69 - $157 | 205% |
| Healthcare Highways [2210] | $69 - $144 | 205% |
| First Health [1375] | $127 - $144 | 377% |
| Cigna | $135 | 400% |
| Planned Administrators Inc [2360] | $144 | 427% |
| Universal Fidelity [2085] | $144 | 427% |
| Administrative Concepts [1005] | $144 | 427% |
| Healthnet [1495] | $144 | 427% |
| Mayo Clinic Health Solutions [2280] | $144 | 427% |
| Resource One Administrators [2815] | $144 | 427% |
| Healthcost Solutions [2415] | $144 | 427% |
| Hometown Health [2155] | $144 | 427% |
| Allied National Global Care [1035] | $144 | 427% |
| Pba [1775] | $144 | 427% |
| New Era Life Insurance Company [1705] | $144 | 427% |
| Mutual of Omaha [1685] | $144 | 427% |
| Multiplan [1680] | $144 | 427% |
| PHCS [1780] | $144 | 427% |
| Gilsbar [1425] | $144 | 427% |
| Pan American Life Insurance Co [1770] | $144 | 427% |
| Healthfirst [2395] | $144 | 427% |
| Trustmark [2030] | $144 | 427% |
| Meritain Health [1655] | $148 | 439% |
| 1199 Seiu Benefit Fund [3505] | $148 | 439% |
| Allied Benefit Systems Inc [1030] | $148 | 439% |
| Humana | $157 | 465% |
| Emblem Health [2430] | $157 | 465% |
| Blue Cross Blue Shield | $166 | 492% |
| Mva [1690] | $169 | 501% |
| Amerihealth [3520] | $169 | 501% |