CMS Price Transparency Data

Orthotic fitting and training

Facility: St David's South Austin Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $54
  • Cash Discount Price: $167
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at St David's South Austin Medical Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.17x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$167

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $167 (362%)
Insurance Median: $54 (117%)
Cash: $167 (362% of Medicare)
Ins. Median: $54 (117% 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
Superior Health Plan $7 - $50 15%
Oscar $27 - $39 59%
Moda $33 - $42 72%
United $35 - $81 76%
Cigna $41 - $52 89%
Covenant Management Systems $41 - $52 89%
Healthcare Highways $41 - $54 89%
Wellmed $41 - $46 89%
Aetna $42 - $99 91%
Blue Cross Blue Shield $42 - $280 91%
Devoted Health $42 - $48 91%
Harbor Hospice $42 - $48 91%
Humana $42 - $48 91%
Odyssey Hospice $42 - $48 91%
St David’S Hospice $42 - $48 91%
Triwest Veterans $42 - $48 91%
Imo Med - Select Network $43 - $54 93%
American Health Plan Of Texas $44 - $50 95%
Amerigroup $44 95%
Shared Health $44 - $50 95%
Provider Partners Health Plan $45 - $51 98%
Pyramid Life $45 - $51 98%
Texas Independent Health Plan $45 - $51 98%
Wellcare $45 - $51 98%
Imperial Insurance $46 - $53 100%
Molina Healthcare $46 - $52 100%
Triwest Health Alliance $47 102%
Universal Health $50 - $57 108%
Moda Health $51 - $67 111%
Austin Fc $53 - $60 115%
Texas Healthcare Foundation Heb $53 - $67 115%
Texas Workforce Commission $55 - $70 119%
Sendero $57 - $82 124%
Averde Health $64 - $81 139%
Naphcare $65 - $74 141%
Seven Corners $65 - $74 141%
Comanche County $71 - $90 154%
Emerging Therapy Solutions $71 - $124 154%
National Choicecare $71 - $90 154%
Healthsmart Preferred Care $78 - $144 169%
Independent Medical Systems $78 - $99 169%
Physicians Cooperative Of Texas $78 - $99 169%
Corvel Corporation $83 - $95 180%
Prime Health $85 - $108 184%
First Health $89 - $129 193%
Coastal Comp Health Networks $92 - $117 200%
National Health Care $92 - $117 200%
Occunet $99 - $126 215%
Texas Municipal League $99 - $126 215%
UnitedHealthcare $105 - $180 228%
Medcorp Southwest $106 - $135 230%
Rockport Healthcare Group $114 - $162 247%
Bce Emergis Corporation $128 - $162 278%
Beech Street $128 - $162 278%
Medical Control Network Solutions $128 - $162 278%
Multiplan $128 - $162 278%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals