CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Methodist McKinney Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $54
Cash Discount Price: $103
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Methodist McKinney Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.60x the Medicare baseline. Located in 8000 W Eldorado Pkwy Bldg C Suite C, McKinney, TX.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $103 (305%)

Insurance Median: $54 (160%)

Cash: $103 (305% of Medicare)

Ins. Median: $54 (160% 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	$34 - $143	101%
Blue Cross Blue Shield	$34 - $109	101%
Medicare (plans)	$34 - $36	101%
UnitedHealthcare	$34 - $36	101%
Ust Health Proof [1005]	$34	101%
Wellcare [7016]	$34	101%
American Health Advantage Of Texas [7099]	$36	107%
Cigna	$36	107%
Globalhealth [1003]	$36	107%
Humana	$36	107%
Procare Advantage [7018]	$36	107%
Southwestern Health Resources Swhr [7015]	$36	107%
Provider Partners Health Plan [7025]	$37	110%
Alternative Service Concepts [8005]	$42	125%
Oscar Insurance Company [2057]	$44	130%
Bright Healthcare [2222]	$47	139%
Molina [3017]	$49	145%
Wellpoint Marketplace Exchange [3071]	$53	157%
90 Degree Benefit [3057]	$56	166%
Allied National [2031]	$56	166%
Entrust/90 Degree [2058]	$56	166%
Ambetter / Centene	$58	172%
Friday Health Plan [2061]	$58	172%
Imperial Insurance Companies [3073]	$61	181%
Evry Health [1013]	$68	202%
Sana Benefits [3069]	$68	202%
Velocity [3070]	$68	202%
Web Tpa [3049]	$107 - $143	317%

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 $103.
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 Methodist McKinney Hospital 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.