CMS Price Transparency Data

Physical therapy (gait training)

Facility: Medical City Dallas Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $199
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Medical City Dallas Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 7777 Forest Lane, Dallas, TX.
Cash / Self-Pay
$199

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $199 (685%)
Insurance Median: $32 (110%)
Cash: $199 (685% of Medicare)
Ins. Median: $32 (110% 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 $14 - $31 48%
UnitedHealthcare $22 - $177 76%
Wellmed $25 - $29 86%
Aetna $26 - $179 89%
Amerigroup $26 - $29 89%
Blue Cross Blue Shield $26 - $166 89%
Care N Care $26 - $29 89%
Cigna $26 - $109 89%
Devoted Health $26 - $29 89%
Humana $26 - $214 89%
Integranet $26 - $30 89%
Mutual Of Omaha $26 - $29 89%
Triwest Veterans $26 - $29 89%
United $26 - $43 89%
Wellcare $26 - $30 89%
American Health Plan Of Texas, Inc. $27 - $31 93%
Procare Advantge $27 - $31 93%
Provider Partners Health Plan $27 - $31 93%
Texas Independent Health Plan $27 - $31 93%
Imperial Insurance Company $28 - $32 96%
Molina $28 - $32 96%
Triwest Health Alliance $29 100%
Universal Healthcare Group $31 - $35 107%
Verda Health Plan $33 - $38 114%
Bravo Health $38 - $44 131%
Religious Order Of Jehovah Witness $40 138%
Oscar $41 141%
Superior $46 - $65 158%
Unicare $48 - $199 165%
Usa Managed Care $49 - $159 169%
Corvel Corporation $51 - $58 175%
Healthcare Highways $67 231%
Molina Healthcare $67 - $76 231%
Healthcare Highways Ntx $70 241%
Prominence Health Plan $79 272%
City Of Mckinney $89 306%
Fidelis Securecare $89 306%
Emerging Therapy Solutions $97 - $139 334%
National Choicecare $99 341%
Pc Texas Partners $109 375%
Physicians Coop Of Tx $109 375%
Rockport Health Group $109 375%
Texas Instruments $111 382%
Averde Health, Inc $115 396%
Coastal Comp Health Networks $139 478%
Mega Life $139 478%
Multiplan Phcs $139 478%
Healthsmart Preferred Care $141 485%
Lewisville Isd/Dls Consulting $149 513%
Usc Health Services $159 547%
Galaxy Health Network $169 582%
Independent Medical Systems $199 685%
National Healthcare Solutions $199 685%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7777 Forest Lane, Dallas, TX 75230
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals