CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Houston Healthcare Southeast

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $59
  • Cash Discount Price: $343
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Houston Healthcare Southeast is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.46x the Medicare baseline. Located in 4000 Spencer Hwy, Pasadena, TX.
Cash / Self-Pay
$343

Average discount available for prompt cash payment at this facility.

Insurance Median
$59

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: $343 (849%)
Insurance Median: $59 (146%)
Cash: $343 (849% of Medicare)
Ins. Median: $59 (146% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Superior Health Plan $21 - $43 52%
Oscar $40 - $67 99%
Amerigroup $41 - $48 101%
Blue Cross Blue Shield $41 - $144 101%
Chc Harris Health $41 101%
Christus (Usfhp) $41 101%
Cigna $41 - $274 101%
Devoted Health $41 101%
Humana $41 - $388 101%
Kelsey Seybold $41 101%
Renaissance Ipa Radiology $41 101%
Triwest Healthcare Alliance $41 101%
United $41 - $154 101%
Van Lang Ipa $41 101%
Wellmed $41 101%
Integranet Amerigroup Ipa $42 104%
Wellcare $42 104%
American Health Plan $43 106%
Procare Advantage $43 106%
Provider Partners Health Plan Of Texas $43 106%
Shared Health $43 106%
Molina $44 109%
Community Health Choice Mcd $45 111%
Kindred Hospital $47 116%
Universal Healthcare Group $49 121%
Verda Health Plan $53 131%
Community Health Choice $59 146%
Superior $59 - $63 146%
Texas Childrens Health Plans $60 - $81 148%
Corvel Corporation $80 198%
Texas Workforce Commission $82 203%
Omni Healthcare $85 210%
Molina Healthcare $87 215%
Aetna $91 - $148 225%
Healthsmart Preferred Care $147 - $291 364%
Fidelis Securecare Of Tx $154 381%
Multiplan $171 - $308 423%
Coventry National First Health $183 453%
Physicians Cooperative Of Texas $188 465%
Rockport Workers Comp $188 465%
Beech Street $206 - $274 510%
Independent Medical System $206 510%
National Healthcare Solutions $206 510%
Prime Health Services $206 510%
Southwest Medical $206 510%
Coastal Comp $223 552%
Fiesta Mart, Inc $257 636%
Physicians, Inc $291 720%
Texas Athletic Network $300 - $600 742%
Affiliated Ppo $308 762%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Spencer Hwy, Pasadena, TX 77504
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals