CMS Price Transparency Data

Orthotic fitting and training

Facility: Ascension Seton Northwest

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $44
Cash Discount Price: $88
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Ascension Seton Northwest is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.95x the Medicare baseline. Located in 11113 Research Boulevard, Austin, TX.

Cash / Self-Pay

$88

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $88 (191%)

Insurance Median: $44 (95%)

Cash: $88 (191% of Medicare)

Ins. Median: $44 (95% 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
Tricare	$39 - $44	85%
Aarp Mc Wellmed	$43	93%
Addr Cancer Together	$44	95%
Aetna	$44	95%
Covid Hrsa	$44	95%
Cshcn Cidc	$44	95%
Devoted Health Mcr Replacement	$44	95%
Humana	$44	95%
Medicare (plans)	$44	95%
Research Study	$44	95%
Sendero Chap	$44	95%
Smarthealth	$44	95%
Superior Allwell	$44	95%
Wellcare Med Advantage	$44	95%
UnitedHealthcare	$45	98%
Connected Senior Care	$46	100%
Pphp Mcr Advantage	$46	100%
Tx Independence Hp	$46	100%
Champva	$47 - $48	102%
Occunet	$62	135%
Sendero Idealcare	$78	169%
Ambetter / Centene	$80	174%
Blue Cross Blue Shield	$83 - $202	180%

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 $88.
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 Ascension Seton Northwest 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.