CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Texas Health Presbyterian Hospital Denton

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $111
Cash Discount Price: $118
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Texas Health Presbyterian Hospital Denton is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.29x the Medicare baseline. Located in 3000 N I-35, Denton, TX.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $118 (350%)

Insurance Median: $111 (329%)

Cash: $118 (350% of Medicare)

Ins. Median: $111 (329% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 329% of the Medicare baseline (a markup of 229%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerigroup	$18 - $34	53%
Blue Cross Blue Shield	$18 - $293	53%
Cook Childrens	$18	53%
UnitedHealthcare	$18 - $401	53%
Superior Wellcare	$19 - $36	56%
Aetna	$20 - $138	59%
Molina	$20 - $34	59%
American Health	$33	98%
Healthspring	$33	98%
Humana	$34	101%
City Of Fort Worth	$92	273%
Quick Trip	$118 - $124	350%
Fort Worth Firefighters	$120 - $250	356%
Phcs	$137 - $147	406%
Healthsmart	$148 - $165	439%
Multiplan	$171	507%
Galaxy	$173	513%
Usa	$173	513%
Cigna	$185 - $396	548%

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 $118.
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 Texas Health Presbyterian Hospital Denton 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.