CMS Price Transparency Data

Prosthetic fitting and training

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $94
Cash Discount Price: $81
vs. Medicare Baseline: 2.33x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at UT of Texas Southwestern University Hospital - William P. Clements Jr. is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.33x the Medicare baseline. Located in 6201 Harry Hines Blvd, Dallas, TX.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $81 (200%)

Insurance Median: $94 (233%)

Cash: $81 (200% of Medicare)

Ins. Median: $94 (233% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $40.41 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 233% of the Medicare baseline (a markup of 133%). 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
Aetna	$23 - $116	57%
Parkland	$23	57%
Superior	$23 - $78	57%
UnitedHealthcare	$23 - $270	57%
Wellpoint	$23 - $45	57%
Molina	$25 - $48	62%
Procare	$41	101%
Ambetter / Centene	$42	104%
Blue Cross Blue Shield	$43 - $260	106%
Humana	$43	106%
United Options Nexus	$44 - $298	109%
Coventry	$64 - $113	158%
Healthfirst	$80 - $90	198%
Maestro Health/Fort Worth Firefighters	$86 - $96	213%
Quiktrip	$92 - $101	228%
Phcs	$95 - $131	235%
Cigna	$96 - $119	238%
Rockwall County	$99 - $113	245%
Galaxy Health Network	$127 - $142	314%
Multiplan	$127 - $140	314%
Healthsmart	$134 - $142	332%

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 $81.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97761.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UT of Texas Southwestern University Hospital - William P. Clements Jr. is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97761.
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.