CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: PAM Rehabilitation Hospital of Round Rock

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $50
Cash Discount Price: $152
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at PAM Rehabilitation Hospital of Round Rock is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.48x the Medicare baseline. Located in 351 Seton Pkwy, Round Rock, TX.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $152 (451%)

Insurance Median: $50 (148%)

Cash: $152 (451% of Medicare)

Ins. Median: $50 (148% 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
Whole Foods (Employers Health Network)	$13 - $57	39%
Aetna	$17 - $104	50%
Blue Cross Blue Shield	$22 - $125	65%
Curative	$24	71%
Seton Health Plan	$28 - $125	83%
Healthcare Highways	$30 - $137	89%
Baylor Scott And White Health Plan	$32	95%
Christus Health Plan	$32	95%
Humana	$32 - $169	95%
Ilumed Aco Reach	$32	95%
Sendero Health Plan	$32 - $56	95%
Wellcare Complete	$32	95%
Wellmed	$32	95%
Wellpoint (Amerigroup)	$32	95%
UnitedHealthcare	$33 - $110	98%
America'S Choice Provider	$39 - $175	116%
Velocity Provider Ppo Network	$39 - $187	116%
Prime Health Services	$42 - $212	125%
Quik Trip	$42 - $187	125%
Usa Managed Care Organization	$42 - $187	125%
Multiplan/Phcs	$44 - $199	130%
Ninety Degree Benefits	$48	142%
Provider Network Of America	$50 - $224	148%
Ambetter / Centene	$58	172%
Cigna	$70	208%
Oscar	$75 - $90	222%
Superior Health Plan	$75	222%

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 $152.
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 PAM Rehabilitation Hospital of Round Rock 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.