CMS Price Transparency Data

Prosthetic fitting and training

Facility: Rio Grande Regional Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $41
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Rio Grande Regional Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.01x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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%)
Insurance Median: $41 (101%)
Ins. Median: $41 (101% 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
Wellmed $38 94%
Allegian Health $39 97%
Blue Cross Blue Shield $39 - $244 97%
Cigna $39 97%
Humana $39 - $543 97%
Independent Medical System $39 97%
Triwest Health Alliance $39 97%
Triwest Healthcare Alliance $39 97%
Aetna $40 99%
United $40 99%
American Health Plan $41 101%
Physicians Health Choice $41 101%
Prominence Health $41 101%
Shared Health $41 101%
Superior Health Plan $41 101%
Provider Partners Health Plan Of Texas $42 104%
Molina $43 106%
Universal Health Care $47 116%
Superior $61 151%
Corvel Corporation $78 193%
Focus Healthcare $78 193%
Omni Healthcare $82 203%
Molina Healthcare $95 235%

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