CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Warm Springs Rehabilitation Hospital of San Antonio

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $44
Cash Discount Price: $59
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Warm Springs Rehabilitation Hospital of San Antonio is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.30x the Medicare baseline. Located in 5101 Medical Dr, San Antonio, TX.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $59 (175%)

Insurance Median: $44 (130%)

Cash: $59 (175% of Medicare)

Ins. Median: $44 (130% 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.

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
Aetna	$6 - $27	18%
Curative	$24	71%
Imperial Insurance Of Texas	$24 - $106	71%
Scan Health Plan	$24 - $106	71%
Ninety Degree Benefits	$29 - $133	86%
Baylor Scott And White Health Plan	$32 - $120	95%
Blue Cross Blue Shield	$32 - $35	95%
Christus Health Plan	$32	95%
Healthcare Highways	$32 - $146	95%
Ilumed Aco Reach	$32	95%
Integranet Health	$32	95%
Molina Healthcare	$32	95%
Premier Health	$32	95%
Wellmed	$32	95%
Wellpoint (Amerigroup)	$32	95%
Provider Partners Health Plan	$34	101%
Integrated Medical Solutions	$36	107%
Velocity Provider Ppo Network	$39 - $199	116%
America'S Choice Provider Network	$41 - $186	122%
Prime Health Services	$42 - $225	125%
Galaxy Health	$44 - $199	130%
Provider Network Of America	$44 - $199	130%
Quik Trip	$44 - $199	130%
Usa Managed Care Organization	$44 - $199	130%
Multiplan/Phcs	$47 - $212	139%
Three Rivers	$47 - $212	139%
Medincrease	$53 - $239	157%
Cigna	$70 - $115	208%
Humana	$70	208%
Community First Health Plans	$80 - $105	237%
Ambetter / Centene	$90	267%
UnitedHealthcare	$90	267%
Independent Medical Systems	$102	302%

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 $59.
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 Warm Springs Rehabilitation Hospital of San Antonio 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.