CMS Price Transparency Data

Orthotic fitting and training

Facility: Texas Health Presbyterian Hospital Allen

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $146
Cash Discount Price: $126
vs. Medicare Baseline: 3.17x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Texas Health Presbyterian Hospital Allen is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.17x the Medicare baseline. Located in 1105 Central Expressway North, Allen, TX.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $126 (273%)

Insurance Median: $146 (317%)

Cash: $126 (273% of Medicare)

Ins. Median: $146 (317% 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 317% of the Medicare baseline (a markup of 217%). 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
Amerigroup	$24 - $47	52%
Blue Cross Blue Shield	$24 - $400	52%
Parkland	$24 - $25	52%
UnitedHealthcare	$24 - $401	52%
Superior Wellcare	$25 - $49	54%
Molina	$26 - $47	56%
American Health	$45	98%
Healthspring	$45	98%
Humana	$46	100%
Aetna	$84 - $150	182%
City Of Fort Worth	$96 - $100	208%
Fort Worth Firefighters	$125 - $250	271%
Quick Trip	$146 - $152	317%
Healthsmart	$154 - $179	334%
Phcs	$172 - $178	373%
Multiplan	$179 - $186	388%
Galaxy	$181 - $188	393%
Usa	$181 - $188	393%
Cigna	$193 - $396	419%

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 $126.
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 Texas Health Presbyterian Hospital Allen 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.