CMS Price Transparency Data

Orthotic fitting and training

Facility: North Austin Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $86
  • Cash Discount Price: $450
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at North Austin Medical Center is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $450. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.87x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$450

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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: $450 (976%)
Insurance Median: $86 (187%)
Cash: $450 (976% of Medicare)
Ins. Median: $86 (187% 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 $22 - $77 48%
Wellmed $41 - $46 89%
Aetna $42 - $254 91%
Blue Cross Blue Shield $42 - $280 91%
Cigna $42 - $48 91%
Devoted Health $42 - $48 91%
Humana $42 - $48 91%
Odyssey Hospice $42 - $48 91%
St David’S Hospice $42 - $48 91%
Triwest Healthcare Alliance $42 - $48 91%
UnitedHealthcare $42 - $205 91%
United $43 - $205 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%
Austin Fc $53 - $60 115%
Sendero $57 - $82 124%
Naphcare $65 - $74 141%
Seven Corners $65 - $74 141%
Corvel Corporation $83 - $95 180%
Oscar $85 - $97 184%
Moda $104 - $107 226%
Covenant Management Systems $128 - $131 278%
Healthcare Highways $129 - $136 280%
Imo Med - Select Network $133 - $136 289%
Moda Health $160 - $168 347%
Texas Healthcare Foundation Heb $164 - $168 356%
Texas Workforce Commission $173 - $177 375%
Averde Health $200 - $205 434%
Comanche County $222 - $228 482%
National Choicecare $222 - $228 482%
Healthsmart Preferred Care $244 - $364 529%
Independent Medical Systems $244 - $250 529%
Physicians Cooperative Of Texas $244 - $250 529%
Prime Health $266 - $273 577%
First Health $278 - $323 603%
Coastal Comp Health Networks $289 - $296 627%
National Health Care $289 - $296 627%
Texas Municipal League $311 - $318 675%
Medcorp Southwest $333 - $341 722%
Rockport Healthcare Group $355 - $410 770%
Bce Emergis Corporation $400 - $410 868%
Beech Street $400 - $410 868%
Medical Control Network Solutions $400 - $410 868%
Multiplan $400 - $410 868%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals