CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $53
Cash Discount Price: $89
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Cook Childrens Medical Center Prosper is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.82x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $89 (306%)

Insurance Median: $53 (182%)

Cash: $89 (306% of Medicare)

Ins. Median: $53 (182% 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.

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 - $48	96%
Health Plan W/O Uhrip	$28 - $78	96%
Superior Health	$31 - $48	107%
Wellpoint	$32 - $50	110%
Blue Cross Blue Shield	$33 - $130	114%
Aetna	$34 - $123	117%
United Community	$34 - $63	117%
UnitedHealthcare	$41 - $123	141%
Beacon	$42 - $78	145%
El Paso Health First	$42 - $78	145%
Tx Children Health	$42 - $78	145%
Firstcare	$45 - $116	155%
S&W Health	$77 - $121	265%
Cigna	$78 - $123	268%
Healthscope	$78 - $123	268%
Imagine Health	$78 - $123	268%
Humana	$80 - $127	275%
Multiplan	$80 - $126	275%
First Health	$81 - $127	279%
Galaxy Health	$83 - $130	286%
Healthsmart	$83 - $130	286%
Usamco	$85 - $133	292%

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 $89.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cook Childrens Medical Center Prosper is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
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.