CMS Price Transparency Data

Physical therapy (gait training)

Facility: Medical Center of McKinney

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $30
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Medical Center of McKinney is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.03x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $116 (399%)
Insurance Median: $30 (103%)
Cash: $116 (399% of Medicare)
Ins. Median: $30 (103% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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.

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
Superior Health Plan $8 - $30 28%
Cigna $16 - $93 55%
United $22 - $28 76%
Oscar $24 83%
Aetna $25 - $179 86%
Amerigroup $25 - $28 86%
Blue Cross Blue Shield $25 - $166 86%
Care N Care $25 - $29 86%
Devoted Health $25 - $28 86%
Humana $25 - $214 86%
Mutual Of Omaha $25 - $28 86%
Triwest Veterans $25 - $28 86%
Wellmed $25 - $28 86%
American Health Plan Of Texas, Inc. $26 - $30 89%
Integranet $26 - $29 89%
Procare Advantge $26 - $30 89%
Provider Partners Health Plan $26 - $30 89%
Texas Independent Health Plan $26 - $30 89%
Wellcare $26 - $29 89%
Cenpatico $27 - $31 93%
Imperial Insurance Company $27 - $31 93%
Molina $27 - $31 93%
Unicare $30 - $116 103%
Universal Healthcare Group $30 - $34 103%
Verda Health Plan $32 - $37 110%
Bravo Health $37 - $42 127%
Healthcare Highways $39 134%
City Of Mckinney $40 138%
Superior $45 - $63 155%
Usa Managed Care $47 - $93 162%
Corvel Corporation $49 - $56 169%
Fidelis Securecare $52 179%
National Choicecare $58 200%
Pc Texas Partners $64 220%
Physicians Coop Of Tx $64 220%
Rockport Health Group $64 220%
Molina Healthcare $65 - $74 224%
Averde Health, Inc $67 231%
Magellan Bh $69 237%
Value Options Behavioral Health $69 237%
Coastal Comp Health Networks $81 279%
Mega Life $81 279%
Multiplan Phcs $81 279%
Lewisville Isd/Dls Consulting $87 299%
Compsych Corporation $93 320%
Healthsmart Preferred Care $93 320%
Galaxy Health Network $98 337%
Independent Medical Systems $116 399%
National Healthcare Solutions $116 399%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals