CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $59
Cash Discount Price: $53
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at UT of Texas Southwestern University Hospital - William P. Clements Jr. is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.75x the Medicare baseline. Located in 6201 Harry Hines Blvd, Dallas, TX.

Cash / Self-Pay

$53

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $53 (157%)

Insurance Median: $59 (175%)

Cash: $53 (157% of Medicare)

Ins. Median: $59 (175% 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.

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
Aetna	$15 - $117	44%
Parkland	$15 - $34	44%
Superior	$15 - $78	44%
UnitedHealthcare	$15 - $270	44%
Wellpoint	$15 - $37	44%
Molina	$16 - $39	47%
Ambetter / Centene	$34	101%
Procare	$34	101%
Blue Cross Blue Shield	$35 - $222	104%
Humana	$35	104%
United Options Nexus	$37 - $298	110%
Maestro Health/Fort Worth Firefighters	$56 - $80	166%
Healthfirst	$59 - $66	175%
Quiktrip	$63 - $76	187%
Coventry	$65 - $73	193%
Rockwall County	$74 - $99	219%
Cigna	$77 - $97	228%
Phcs	$79 - $98	234%
Healthsmart	$87 - $143	258%
Multiplan	$91 - $128	270%
Galaxy Health Network	$92 - $128	273%

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 $53.
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 UT of Texas Southwestern University Hospital - William P. Clements Jr. 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.