CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Medical City Plano

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $49
  • Cash Discount Price: $306
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Medical City Plano is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $306. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.45x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$306

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $306 (907%)
Insurance Median: $49 (145%)
Cash: $306 (907% of Medicare)
Ins. Median: $49 (145% 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.

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 $16 - $34 47%
Blue Cross Blue Shield $28 - $191 83%
Aetna $29 - $236 86%
Amerigroup $29 - $33 86%
Care N Care $29 - $33 86%
Cigna $29 - $83 86%
Devoted Health $29 - $33 86%
Humana $29 - $265 86%
Mutual Of Omaha $29 - $33 86%
Triwest Veterans $29 - $33 86%
United $29 - $68 86%
Wellmed $29 - $33 86%
American Health Plan Of Texas, Inc. $30 - $34 89%
Integranet $30 - $34 89%
Procare Advantge $30 - $34 89%
Wellcare $30 - $34 89%
Molina $31 - $36 92%
Provider Partners Health Plan $31 - $35 92%
Texas Independent Health Plan $31 - $35 92%
Imperial Insurance Company $32 - $36 95%
Triwest Health Alliance $32 95%
Universal Healthcare Group $35 - $39 104%
Verda Health Plan $37 - $43 110%
Bravo Health $43 - $49 127%
Oscar $46 - $81 136%
Superior $52 - $73 154%
Healthcare Highways $54 - $132 160%
Usa Managed Care $55 - $312 163%
Corvel Corporation $57 - $65 169%
Evry Health $57 169%
Lifecare Hospitals $67 - $117 199%
Molina Healthcare $76 - $86 225%
Curative Administrators $89 264%
Prominence Health Plan $89 - $156 264%
City Of Mckinney $100 - $175 296%
Fidelis Securecare $100 - $175 296%
National Choicecare $111 - $195 329%
Pc Texas Partners $122 - $214 362%
Physicians Coop Of Tx $122 - $214 362%
Rockport Health Group $122 - $214 362%
Averde Health, Inc $129 - $226 382%
Texas Healthcare Foundation Wc $144 - $253 427%
Coastal Comp Health Networks $155 - $273 460%
Mega Life $155 - $273 460%
Multiplan Phcs $155 - $273 460%
Healthsmart Preferred Care $167 - $292 495%
Lewisville Isd/Dls Consulting $167 - $292 495%
Usc Health Services $178 - $312 528%
Galaxy Health Network $189 - $331 560%
Independent Medical Systems $222 - $390 658%
National Healthcare Solutions $222 - $390 658%
Unicare $222 - $390 658%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals