CMS Price Transparency Data

Prosthetic fitting and training

Facility: University of Texas M. D. Anderson Cancer Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $116
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.87x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at University of Texas M. D. Anderson Cancer Center is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.87x the Medicare baseline. Located in 1515 Holcombe Blvd, Houston, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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%)

Insurance Median: $116 (287%)

Ins. Median: $116 (287% 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 287% of the Medicare baseline (a markup of 187%). 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
Texaschildrens	$31 - $68	77%
Tricare	$35 - $116	87%
Cigna	$54 - $202	134%
Aetna	$57 - $116	141%
Medicare (plans)	$68	168%
Vacare	$68	168%
Blue Cross Blue Shield	$74 - $111	183%
Memorialhermannhealth	$100 - $178	247%
UnitedHealthcare	$108 - $178	267%
Humana	$114 - $198	282%
Ontarioministriesofhealth	$114 - $176	282%
Beijingst.Lucia	$116 - $178	287%
Embassyofqatar	$116 - $178	287%
Emergingtherapysolutions	$116 - $123	287%
Interlink	$116 - $131	287%
Emergingtherapysolutions_Cancercare	$123 - $190	304%
Interlink_Cancercare	$123 - $190	304%
Saudiarmedforces	$123 - $190	304%
Uae_Medical	$123 - $190	304%
Uaepoliceattache	$123 - $190	304%
Healthsmart	$131 - $202	324%
Multiplan	$131 - $214	324%
Phcs	$131 - $214	324%
Vantage	$131 - $202	324%

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 $X.
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 University of Texas M. D. Anderson Cancer Center 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.