CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Texas Orthopedic Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $37
  • Cash Discount Price: $714
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Texas Orthopedic Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $714. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$714

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $714 (2117%)
Insurance Median: $37 (110%)
Cash: $714 (2117% of Medicare)
Ins. Median: $37 (110% 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 $10 - $76 30%
Community Health Choice Mcd $22 - $164 65%
Amerigroup $23 - $177 68%
Texas Childrens Health Plans $28 - $299 83%
Oscar $29 - $246 86%
Blue Cross Blue Shield $30 - $442 89%
Cigna $30 - $34 89%
Devoted Health $30 - $34 89%
Humana $30 - $361 89%
Kelsey Seybold $30 - $34 89%
Triwest Healthcare Alliance $30 - $34 89%
United $30 - $568 89%
Van Lang Ipa $30 - $34 89%
Wellmed $30 - $34 89%
American Health Plan $31 - $36 92%
Integranet Amerigroup Ipa $31 - $35 92%
Procare Advantage $31 - $36 92%
Shared Health $31 - $36 92%
Wellcare $31 - $35 92%
Molina $32 - $37 95%
Provider Partners Health Plan Of Texas $32 - $36 95%
Aetna $34 - $433 101%
Christus (Usfhp) $34 101%
Universal Healthcare Group $36 - $41 107%
Verda Health Plan $39 - $44 116%
Texas Workforce Commission $40 - $303 119%
Community Health Choice $43 - $49 127%
Superior $43 - $52 127%
Corvel Corporation $59 - $67 175%
Omni Healthcare $63 - $71 187%
Molina Healthcare $65 - $74 193%
Healthsmart Preferred Care $71 - $1,073 210%
Fidelis Securecare Of Tx $75 - $568 222%
Coventry National First Health $88 - $673 261%
Physicians Cooperative Of Texas $91 - $694 270%
Rockport Workers Comp $91 - $694 270%
Independent Medical System $100 - $757 296%
National Healthcare Solutions $100 - $757 296%
Southwest Medical $100 - $757 296%
Coastal Comp $108 - $820 320%
Multiplan $124 - $1,073 368%
International Health Insurance $133 - $1,010 394%
Physicians, Inc $141 - $1,073 418%
Affiliated Ppo $149 - $1,136 442%
Texas Athletic Network $300 - $600 889%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals