CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: St David's South Austin Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $48
  • Cash Discount Price: $215
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at St David's South Austin Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.42x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$215

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $215 (637%)
Insurance Median: $48 (142%)
Cash: $215 (637% of Medicare)
Ins. Median: $48 (142% 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 $8 - $45 24%
Wellmed $30 - $34 89%
Aetna $31 - $146 92%
Blue Cross Blue Shield $31 - $205 92%
Cigna $31 - $77 92%
Devoted Health $31 - $35 92%
Harbor Hospice $31 - $35 92%
Humana $31 - $35 92%
Odyssey Hospice $31 - $35 92%
St David’S Hospice $31 - $35 92%
Triwest Veterans $31 - $35 92%
United $31 - $119 92%
American Health Plan Of Texas $32 - $37 95%
Oscar $32 - $57 95%
Provider Partners Health Plan $32 - $37 95%
Shared Health $32 - $37 95%
Texas Independent Health Plan $32 - $37 95%
Wellcare $32 - $37 95%
Molina Healthcare $33 - $38 98%
Pyramid Life $33 - $37 98%
Amerigroup $34 101%
Imperial Insurance $34 - $38 101%
Triwest Health Alliance $34 101%
Universal Health $37 - $42 110%
Austin Fc $38 - $43 113%
Moda $39 - $62 116%
Sendero $41 - $59 122%
Naphcare $47 - $54 139%
Seven Corners $47 - $54 139%
Covenant Management Systems $48 - $76 142%
Healthcare Highways $48 - $80 142%
Imo Med - Select Network $50 - $80 148%
Moda Health $59 - $98 175%
Corvel Corporation $61 - $69 181%
Texas Healthcare Foundation Heb $61 - $98 181%
Texas Workforce Commission $64 - $103 190%
Averde Health $74 - $119 219%
UnitedHealthcare $77 - $265 228%
Comanche County $82 - $132 243%
Emerging Therapy Solutions $82 - $183 243%
National Choicecare $82 - $132 243%
Healthsmart Preferred Care $91 - $212 270%
Independent Medical Systems $91 - $146 270%
Physicians Cooperative Of Texas $91 - $146 270%
Prime Health $99 - $159 294%
First Health $104 - $191 308%
Coastal Comp Health Networks $107 - $172 317%
National Health Care $107 - $172 317%
Occunet $116 - $186 344%
Texas Municipal League $116 - $186 344%
Medcorp Southwest $124 - $199 368%
Rockport Healthcare Group $132 - $238 391%
Bce Emergis Corporation $148 - $238 439%
Beech Street $148 - $238 439%
Medical Control Network Solutions $148 - $238 439%
Multiplan $148 - $238 439%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals