CMS Price Transparency Data

Orthotic fitting and training

Facility: Baylor Scott and White Medical Center Lake Pointe

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $135
Cash Discount Price: $132
vs. Medicare Baseline: 2.93x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Baylor Scott and White Medical Center Lake Pointe is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.93x the Medicare baseline. Located in 6800 Scenic Dr, Rowlett, TX.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$135

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: $132 (286%)

Insurance Median: $135 (293%)

Cash: $132 (286% of Medicare)

Ins. Median: $135 (293% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 293% of the Medicare baseline (a markup of 193%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Superior Health Plan	$24	52%
Wellpoint (Fka Amerigroup)	$24	52%
UnitedHealthcare	$104 - $115	226%
Blue Cross Blue Shield	$108 - $228	234%
Baylor Scott & White Health Plan	$109 - $128	236%
Aetna	$121	263%
Employers Health Network	$121	263%
Quiktrip	$121	263%
Cigna	$128 - $151	278%
University Of Mary Hardin-Baylor	$128	278%
Texas A&M Commerce	$132	286%
Imagine Health	$138	299%
Ambetter / Centene	$143	310%
Curative	$143	310%
First Health	$154	334%
Healthsmart	$154 - $165	334%
Humana	$154	334%
Private Health Care System	$165	358%
Triwest	$165	358%

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 $132.
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 Baylor Scott and White Medical Center Lake Pointe 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.