CMS Price Transparency Data

Prosthetic fitting and training

Facility: St David's Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $46
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at St David's Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.14x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $260 (643%)
Insurance Median: $46 (114%)
Cash: $260 (643% of Medicare)
Ins. Median: $46 (114% 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 $13 - $44 32%
Amerigroup $34 84%
Wellmed $38 - $41 94%
Aetna $39 - $144 97%
Blue Cross Blue Shield $39 - $240 97%
Cigna $39 - $42 97%
Devoted Health $39 - $42 97%
Humana $39 - $42 97%
Odyssey Hospice $39 - $42 97%
St David’S Hospice $39 - $42 97%
Triwest Health Alliance $39 - $42 97%
Triwest Healthcare Alliance $39 - $42 97%
United $40 - $117 99%
American Health Plan Of Texas $41 - $44 101%
Shared Health $41 - $44 101%
Provider Partners Health Plan $42 - $44 104%
Pyramid Life $42 - $45 104%
Texas Independent Health Plan $42 - $44 104%
Triwest Veterans $42 104%
Wellcare $42 - $44 104%
Imperial Insurance $43 - $46 106%
Molina Healthcare $43 - $46 106%
Universal Health $47 - $50 116%
Austin Fc $49 - $52 121%
Oscar $50 - $56 124%
Sendero $53 - $71 131%
Moda $61 151%
Naphcare $61 - $65 151%
Seven Corners $65 161%
Covenant Management Systems $75 186%
Healthcare Highways $76 - $78 188%
Corvel Corporation $78 - $83 193%
Imo Med - Select Network $78 193%
Moda Health $94 - $96 233%
Texas Healthcare Foundation Heb $96 238%
Texas Workforce Commission $101 250%
Averde Health $117 290%
Comanche County $130 322%
National Choicecare $130 322%
Healthsmart Preferred Care $143 - $208 354%
Independent Medical Systems $143 354%
Physicians Cooperative Of Texas $143 354%
Prime Health $156 386%
First Health $164 - $187 406%
Coastal Comp Health Networks $169 418%
National Health Care $169 418%
Occunet $182 450%
Texas Municipal League $182 450%
Medcorp Southwest $195 483%
Rockport Healthcare Group $208 - $234 515%
Bce Emergis Corporation $234 579%
Beech Street $234 579%
Medical Control Network Solutions $234 579%
Multiplan $234 579%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals