CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Medical Center Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $58
Cash Discount Price: $76
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Medical Center Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.72x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $76 (225%)

Insurance Median: $58 (172%)

Cash: $76 (225% of Medicare)

Ins. Median: $58 (172% 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
Corvel Wc	$15	44%
Medicaid / KanCare	$16 - $17	47%
Superior Chips	$16	47%
UnitedHealthcare	$18 - $160	53%
Aetna	$32 - $79	95%
Humana	$32	95%
Novitas Solutions	$32	95%
Triwest Va Ccn	$32	95%
Care Improvement Plus	$33	98%
Ambetter / Centene	$34	101%
Wellcare By Allwell	$34	101%
Group Resources	$39	116%
Blue Cross Blue Shield	$49 - $88	145%
Health Select	$51 - $66	151%
90 Degree Benefits	$57 - $105	169%
State Comptroller	$60	178%
Workers Comp	$66	196%
Healthsmart Preferred Care	$71 - $111	210%
Texas Mutual Wc	$79	234%
Caprock	$102 - $120	302%
Firstcare	$110	326%
Geha	$147	436%
Cigna	$218	646%

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 $76.
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 Medical Center Hospital 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.