CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Texas Health Presbyterian Hospital Flower Mound

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $124
Cash Discount Price: $122
vs. Medicare Baseline: 4.27x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Texas Health Presbyterian Hospital Flower Mound is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.27x the Medicare baseline. Located in 4400 Long Prairie Road, Flower Mound, TX.

Cash / Self-Pay

$122

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $122 (420%)

Insurance Median: $124 (427%)

Cash: $122 (420% of Medicare)

Ins. Median: $124 (427% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 427% of the Medicare baseline (a markup of 327%). 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
American Health	$28	96%
Blue Cross Blue Shield	$28 - $257	96%
Healthspring	$29	100%
Humana	$29	100%
Amerigroup	$30 - $31	103%
Cook Childrens	$30 - $31	103%
Molina	$30 - $34	103%
Superior Wellcare	$30 - $33	103%
UnitedHealthcare	$30 - $401	103%
Aetna	$33 - $145	114%
City Of Fort Worth	$93 - $97	320%
Quick Trip	$119 - $130	409%
Fort Worth Firefighters	$121 - $250	416%
Phcs	$138 - $154	475%
Healthsmart	$149 - $173	513%
Multiplan	$173 - $180	595%
Galaxy	$175 - $182	602%
Usa	$175 - $182	602%
Cigna	$187 - $396	643%

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 $122.
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 Texas Health Presbyterian Hospital Flower Mound 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.