CMS Price Transparency Data

Physical therapy (gait training)

Facility: Medical City Lewisville

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $31
  • Cash Discount Price: $305
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Medical City Lewisville is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.
Cash / Self-Pay
$305

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $305 (1050%)
Insurance Median: $31 (107%)
Cash: $305 (1050% of Medicare)
Ins. Median: $31 (107% 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 $21 - $30 72%
Aetna $25 - $222 86%
Amerigroup $25 - $28 86%
Blue Cross Blue Shield $25 - $166 86%
Care N Care $25 - $29 86%
Cigna $25 - $43 86%
Devoted Health $25 - $28 86%
Humana $25 - $214 86%
Mutual Of Omaha $25 - $28 86%
Triwest Health Alliance $25 - $28 86%
United $25 - $61 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%
Imperial Insurance Company $27 - $31 93%
Molina $27 - $31 93%
Universal Healthcare Group $30 - $34 103%
Verda Health Plan $32 - $37 110%
Bravo Health $37 - $42 127%
Superior $45 - $63 155%
Usa Managed Care $47 - $244 162%
Corvel Corporation $49 - $56 169%
Oscar $64 220%
Molina Healthcare $65 - $74 224%
Unicare $73 - $305 251%
Healthcare Highways $103 354%
City Of Mckinney $137 471%
Fidelis Securecare $137 471%
National Choicecare $153 526%
Pc Texas Partners $168 578%
Physicians Coop Of Tx $168 578%
Rockport Health Group $168 578%
Averde Health, Inc $177 609%
Usc Health Services $183 630%
Coastal Comp Health Networks $214 736%
Jostens $214 736%
Mega Life $214 736%
Multiplan Phcs $214 736%
Healthsmart Preferred Care $229 788%
Lewisville Isd/Dls Consulting $229 788%
Galaxy Health Network $260 895%
Independent Medical Systems $305 1050%
National Healthcare Solutions $305 1050%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 West Main Street, Lewisville, TX 75057
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals