CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: North Austin Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $65
  • Cash Discount Price: $336
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at North Austin Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $336. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.93x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$336

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $336 (996%)
Insurance Median: $65 (193%)
Cash: $336 (996% of Medicare)
Ins. Median: $65 (193% 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 $17 - $57 50%
Wellmed $30 - $34 89%
Aetna $31 - $188 92%
Blue Cross Blue Shield $31 - $205 92%
Cigna $31 - $35 92%
Devoted Health $31 - $35 92%
Humana $31 - $35 92%
Odyssey Hospice $31 - $35 92%
St David’S Hospice $31 - $35 92%
Triwest Healthcare Alliance $31 - $35 92%
United $31 - $152 92%
UnitedHealthcare $31 - $152 92%
American Health Plan Of Texas $32 - $37 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%
Sendero $41 - $59 122%
Naphcare $47 - $54 139%
Seven Corners $47 - $54 139%
Corvel Corporation $61 - $69 181%
Oscar $64 - $72 190%
Moda $79 234%
Covenant Management Systems $96 - $97 285%
Healthcare Highways $97 - $101 288%
Imo Med - Select Network $100 - $101 296%
Moda Health $121 - $125 359%
Texas Healthcare Foundation Heb $124 - $125 368%
Texas Workforce Commission $131 388%
Averde Health $151 - $152 448%
Comanche County $168 498%
National Choicecare $168 498%
Healthsmart Preferred Care $184 - $270 546%
Independent Medical Systems $184 - $185 546%
Physicians Cooperative Of Texas $184 - $185 546%
Prime Health $201 - $202 596%
First Health $209 - $239 620%
Coastal Comp Health Networks $218 - $219 646%
National Health Care $218 - $219 646%
Texas Municipal League $234 - $236 694%
Medcorp Southwest $251 - $253 744%
Rockport Healthcare Group $268 - $303 795%
Bce Emergis Corporation $302 - $303 895%
Beech Street $302 - $303 895%
Medical Control Network Solutions $302 - $303 895%
Multiplan $302 - $303 895%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals