CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Medical City Arlington

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $34
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Medical City Arlington is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 3301 Matlock Road, Arlington, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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%)

Insurance Median: $34 (101%)

Ins. Median: $34 (101% 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
Blue Cross Blue Shield	$29 - $191	86%
Wellmed	$29 - $33	86%
Aetna	$30 - $34	89%
Amerigroup	$30 - $34	89%
Care N Care	$30 - $34	89%
Cigna	$30 - $34	89%
Devoted Health	$30 - $34	89%
Humana	$30 - $265	89%
Integranet	$30 - $35	89%
Mutual Of Omaha	$30 - $34	89%
Triwest Veterans	$30 - $34	89%
United	$30 - $34	89%
Wellcare	$30 - $35	89%
American Health Plan Of Texas, Inc.	$31 - $35	92%
Procare Advantge	$31 - $35	92%
Provider Partners Health Plan	$31 - $36	92%
Superior Health Plan	$31 - $35	92%
Texas Independent Health Plan	$31 - $36	92%
Imperial Insurance Company	$32 - $37	95%
Molina	$32 - $37	95%
Triwest Health Alliance	$33	98%
Universal Healthcare Group	$35 - $40	104%
Verda Health Plan	$38 - $44	113%
Bravo Health	$44 - $50	130%
Superior	$53 - $75	157%
Usa Managed Care	$56 - $64	166%
Corvel Corporation	$58 - $66	172%
Molina Healthcare	$77 - $88	228%

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 $X.
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 City Arlington 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.