CMS Price Transparency Data

Orthotic fitting and training

Facility: Carrollton Regional Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $45
Cash Discount Price: $111
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Carrollton Regional Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.98x the Medicare baseline. Located in 4343 North Josey Lane, Carrollton, TX.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $111 (241%)

Insurance Median: $45 (98%)

Cash: $111 (241% of Medicare)

Ins. Median: $45 (98% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$23 - $67	50%
Amerigroup	$26 - $45	56%
Blue Cross Blue Shield	$26 - $175	56%
Cigna	$26	56%
Medicaid / KanCare	$26 - $27	56%
Molina	$26 - $46	56%
Superior	$26 - $67	56%
Superior_Chip	$26	56%
Uhc_Chip	$26	56%
Uhc_Star	$26	56%
Uhc_Star_Plus	$26	56%
UnitedHealthcare	$26 - $167	56%
Humana	$40 - $45	87%
Medicare (plans)	$45	98%
Scott_And_White	$45	98%
Molina_Star_Plus	$46	100%
Molina_Health_Insurance_Marketplace	$58	126%
Scott_And_White_Epo	$92	200%
Scott_And_White_Hmo	$92	200%
Scott_And_White_Ppo	$92	200%
Scott_And_White_Swhp	$92	200%
Phcs	$138	299%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $111.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97760.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Carrollton Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97760.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.