CMS Price Transparency Data

Prosthetic fitting and training

Facility: Harlingen Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $39
Cash Discount Price: $39
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Harlingen Medical Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.97x the Medicare baseline. Located in 5501 South Expressway 77, Harlingen, TX.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $39 (97%)

Insurance Median: $39 (97%)

Cash: $39 (97% of Medicare)

Ins. Median: $39 (97% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $40.41 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	$39	97%
Blue Cross Blue Shield	$39 - $125	97%
Careworks Worker Compensation Fka Rockport Community Network	$39	97%
Cigna	$39 - $40	97%
Humana	$39	97%
Medicare (plans)	$39	97%
San Benito Medical Associates	$39	97%
Superior Health Plan	$39	97%
Texas Bluebonnett Health Plan	$39 - $65	97%
Tricare	$39	97%
UnitedHealthcare	$39	97%
Veterans Evaluation Services	$39	97%
Wellmed	$39	97%
Workers Compensation	$39	97%
Molina	$41 - $61	101%
Provider Partners Health Plan	$41	101%
Imperial Insurance Company	$42	104%
Asserta Health	$51	126%
Friday Health Plan	$51	126%
Magic Valley Electric Cooperative	$51	126%
Superior Health Commercial Exchange	$51	126%
Employer Direct Healthcare	$55	136%
Corporate Remedies Worker Compensation	$59	146%
Naphcare	$61	151%
Baker Benefits Administrators	$78	193%

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 $39.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97761.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Harlingen Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97761.
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.