CMS Price Transparency Data

Physical therapy (gait training)

Facility: Medical City Las Colinas

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $31
  • Cash Discount Price: $426
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Medical City Las Colinas is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $426. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 6800 N Macarthur Blvd, Irving, TX.
Cash / Self-Pay
$426

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $426 (1466%)
Insurance Median: $31 (107%)
Cash: $426 (1466% of Medicare)
Ins. Median: $31 (107% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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
Wellmed $25 - $29 86%
Aetna $26 - $311 89%
Amerigroup $26 - $29 89%
Blue Cross Blue Shield $26 - $189 89%
Care N Care $26 - $29 89%
Cigna $26 - $60 89%
Devoted Health $26 - $29 89%
Humana $26 - $214 89%
Integranet $26 - $30 89%
Mutual Of Omaha $26 - $29 89%
Triwest Veterans $26 - $29 89%
United $26 - $76 89%
Wellcare $26 - $30 89%
American Health Plan Of Texas, Inc. $27 - $31 93%
Procare Advantge $27 - $31 93%
Provider Partners Health Plan $27 - $31 93%
Superior Health Plan $27 - $31 93%
Texas Independent Health Plan $27 - $31 93%
Imperial Insurance Company $28 - $32 96%
Molina $28 - $32 96%
Triwest Health Alliance $29 100%
Universal Healthcare Group $31 - $35 107%
Verda Health Plan $33 - $38 114%
Bravo Health $38 - $44 131%
Superior $46 - $65 158%
Usa Managed Care $49 - $340 169%
Corvel Corporation $51 - $58 175%
Molina Healthcare $67 - $76 231%
Oscar $89 306%
Healthcare Highways $144 496%
Unicare $149 - $426 513%
City Of Mckinney $192 661%
National Choicecare $213 733%
Pc Texas Partners $234 805%
Physicians Coop Of Tx $234 805%
Rockport Health Group $234 805%
Averde Health, Inc $247 850%
Coastal Comp Health Networks $298 1025%
Mega Life $298 1025%
Multiplan Phcs $298 1025%
Healthsmart Preferred Care $302 1039%
Lewisville Isd/Dls Consulting $319 1098%
Usc Health Services $340 1170%
Galaxy Health Network $362 1246%
Independent Medical Systems $426 1466%
National Healthcare Solutions $426 1466%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 N Macarthur Blvd, Irving, TX 75039
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals