CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Texas Health Presbyterian Hospital Flower Mound

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $96
Cash Discount Price: $94
vs. Medicare Baseline: 2.85x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Texas Health Presbyterian Hospital Flower Mound is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.85x the Medicare baseline. Located in 4400 Long Prairie Road, Flower Mound, TX.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $94 (279%)

Insurance Median: $96 (285%)

Cash: $94 (279% of Medicare)

Ins. Median: $96 (285% 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 285% of the Medicare baseline (a markup of 185%). 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
Amerigroup	$24 - $34	71%
Blue Cross Blue Shield	$24 - $293	71%
Cook Childrens	$24	71%
UnitedHealthcare	$24 - $401	71%
Molina	$25 - $34	74%
Superior Wellcare	$25 - $36	74%
Aetna	$26 - $110	77%
American Health	$33	98%
Healthspring	$33	98%
Humana	$34	101%
City Of Fort Worth	$74	219%
Quick Trip	$94 - $99	279%
Fort Worth Firefighters	$96 - $250	285%
Phcs	$109 - $117	323%
Healthsmart	$117 - $131	347%
Multiplan	$136	403%
Galaxy	$138	409%
Usa	$138	409%
Cigna	$147 - $396	436%

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 $94.
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 Texas Health Presbyterian Hospital Flower Mound 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.