CMS Price Transparency Data

Orthotic fitting and training

Facility: Rio Grande Regional Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $47
  • Cash Discount Price: $805
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Rio Grande Regional Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $805. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.02x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$805

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$46.09

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $46.09 (100%)
Cash / Self-Pay: $805 (1747%)
Insurance Median: $47 (102%)
Cash: $805 (1747% of Medicare)
Ins. Median: $47 (102% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $46.09 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
Wellmed $38 - $44 82%
Allegian Health $39 - $45 85%
Blue Cross Blue Shield $39 - $362 85%
Cigna $39 - $45 85%
Humana $39 - $626 85%
Independent Medical System $39 - $45 85%
Triwest Healthcare Alliance $39 - $45 85%
Aetna $40 - $370 87%
United $40 - $362 87%
American Health Plan $41 - $47 89%
Physicians Health Choice $41 - $47 89%
Prominence Health $41 - $47 89%
Shared Health $41 - $47 89%
Superior Health Plan $41 - $56 89%
Provider Partners Health Plan Of Texas $42 - $47 91%
Molina $43 - $49 93%
Triwest Health Alliance $44 95%
Universal Health Care $47 - $54 102%
Superior $61 - $69 132%
Corvel Corporation $78 - $88 169%
Focus Healthcare $78 - $89 169%
Omni Healthcare $82 - $94 178%
Molina Healthcare $95 - $108 206%
Texas Workforce Commission $193 419%
Oscar $219 475%
Averde Health $266 577%
Texas Athletic Network $300 - $600 651%
Healthsmart Preferred Care $346 - $684 751%
First Health $463 1005%
National Healthcare Solutions $483 1048%
Southwest Medical $483 1048%
Coastal Comp $523 1135%
Usa Managed Care $523 - $644 1135%
Ppo Next/ Medical Control $604 1310%
Beech Street $644 1397%
Multiplan $644 1397%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals