CMS Price Transparency Data

Prosthetic fitting and training

Facility: Medical City Plano

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $58
  • Cash Discount Price: $228
  • vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Medical City Plano is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.44x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$228

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $228 (564%)
Insurance Median: $58 (144%)
Cash: $228 (564% of Medicare)
Ins. Median: $58 (144% 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 $16 - $41 40%
Cigna $31 - $40 77%
Aetna $37 - $138 92%
Humana $38 - $285 94%
Amerigroup $39 97%
Blue Cross Blue Shield $39 - $224 97%
Devoted Health $39 97%
Mutual Of Omaha $39 97%
Triwest Health Alliance $39 97%
Triwest Veterans $39 97%
United $39 - $40 97%
Wellmed $39 97%
Care N Care $40 99%
Integranet $40 99%
Wellcare $40 99%
American Health Plan Of Texas, Inc. $41 101%
Procare Advantge $41 101%
Provider Partners Health Plan $42 104%
Texas Independent Health Plan $42 104%
Imperial Insurance Company $43 106%
Molina $43 106%
Oscar $47 116%
Universal Healthcare Group $47 116%
Verda Health Plan $51 126%
Bravo Health $59 146%
Lifecare Hospitals $68 168%
Superior $70 - $88 173%
Usa Managed Care $74 - $182 183%
Healthcare Highways $77 191%
Corvel Corporation $78 193%
Prominence Health Plan $91 225%
City Of Mckinney $102 252%
Fidelis Securecare $102 252%
Molina Healthcare $103 255%
National Choicecare $114 282%
Pc Texas Partners $125 309%
Physicians Coop Of Tx $125 309%
Rockport Health Group $125 309%
Averde Health, Inc $132 327%
Texas Healthcare Foundation Wc $148 366%
Coastal Comp Health Networks $159 393%
Mega Life $159 393%
Multiplan Phcs $159 393%
Healthsmart Preferred Care $171 423%
Lewisville Isd/Dls Consulting $171 423%
Usc Health Services $182 450%
Galaxy Health Network $194 480%
Independent Medical Systems $228 564%
National Healthcare Solutions $228 564%
Unicare $228 564%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals