CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Rio Grande Regional Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $33
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Rio Grande Regional Hospital is $33. 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 0.98x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $33 (98%)

Ins. Median: $33 (98% 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
Wellmed	$28 - $32	83%
Aetna	$29 - $33	86%
Allegian Health	$29 - $33	86%
Blue Cross Blue Shield	$29 - $208	86%
Cigna	$29 - $33	86%
Humana	$29 - $505	86%
Independent Medical System	$29 - $33	86%
Triwest Healthcare Alliance	$29 - $33	86%
United	$29 - $33	86%
American Health Plan	$30 - $34	89%
Physicians Health Choice	$30 - $34	89%
Prominence Health	$30 - $34	89%
Shared Health	$30 - $34	89%
Superior Health Plan	$30 - $34	89%
Molina	$31 - $36	92%
Provider Partners Health Plan Of Texas	$31 - $35	92%
Triwest Health Alliance	$32	95%
Universal Health Care	$35 - $39	104%
Superior	$45 - $51	133%
Corvel Corporation	$57 - $65	169%
Focus Healthcare	$58 - $66	172%
Omni Healthcare	$61 - $69	181%
Molina Healthcare	$70 - $80	208%

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 Rio Grande Regional Hospital 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.