CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Houston Healthcare Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $43
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Houston Healthcare Medical Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.06x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $203 (502%)
Insurance Median: $43 (106%)
Cash: $203 (502% of Medicare)
Ins. Median: $43 (106% 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 $12 - $43 30%
Community Health Choice Mcd $26 64%
United $34 - $92 84%
Oscar $40 99%
Blue Cross Blue Shield $41 - $135 101%
Christus (Usfhp) $41 101%
Cigna $41 101%
Devoted Health $41 101%
Humana $41 - $388 101%
Triwest Health Alliance $41 101%
Triwest Healthcare Alliance $41 101%
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%
Verda Health Plan $53 131%
Aetna $54 - $88 134%
Community Health Choice $59 146%
Superior $59 - $63 146%
Molina Healthcare $87 215%
Coventry National First Health $108 267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals