CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Cook Childrens Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $121
Cash Discount Price: $216
vs. Medicare Baseline: 3.59x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Cook Childrens Medical Center is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.59x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $216 (640%)

Insurance Median: $121 (359%)

Cash: $216 (640% of Medicare)

Ins. Median: $121 (359% 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 359% of the Medicare baseline (a markup of 259%). 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
Health Plan W. Uhrip	$28 - $166	83%
Health Plan W/O Uhrip	$28 - $146	83%
Rightcare	$30 - $193	89%
Beacon	$35 - $193	104%
Firstcare	$35 - $350	104%
Aetna	$40 - $372	119%
United Community	$51 - $154	151%
Wellpoint	$51 - $154	151%
Blue Cross Blue Shield	$52 - $394	154%
Molina	$53 - $162	157%
El Paso Health First	$63 - $193	187%
Superior Health	$63 - $193	187%
Tx Children Health	$63 - $193	187%
UnitedHealthcare	$63 - $372	187%
S&W Health	$121 - $368	359%
Cigna	$122 - $372	362%
Healthscope	$122 - $372	362%
Imagine Health	$122 - $372	362%
Humana	$125 - $385	371%
Multiplan	$125 - $381	371%
First Health	$127 - $385	377%
Galaxy Health	$130 - $394	385%
Healthsmart	$130 - $394	385%
Usamco	$133 - $403	394%

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 $216.
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 Cook Childrens Medical Center 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.