CMS Price Transparency Data

Orthotic fitting and training

Facility: PAM Specialty Hospital of San Antonio Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $192
Cash Discount Price: $254
vs. Medicare Baseline: 4.17x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at PAM Specialty Hospital of San Antonio Medical Center is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.17x the Medicare baseline. Located in 8902 Floyd Curl Dr, San Antonio, TX.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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: $254 (551%)

Insurance Median: $192 (417%)

Cash: $254 (551% of Medicare)

Ins. Median: $192 (417% 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 417% of the Medicare baseline (a markup of 317%). 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
Aetna	$31	67%
America'S Choice	$176 - $179	382%
Provider Network Of America	$189 - $192	410%
Quik Trip	$189 - $192	410%
Usa Mco	$189 - $192	410%
Velocity Provider Ppo Network	$189 - $192	410%
Evolutions Healthcare System	$201 - $205	436%
Multiplan/Phcs	$201 - $205	436%
Fortified Provider Network	$214 - $218	464%
Prime Health Services	$214 - $218	464%
Medincrease	$226 - $230	490%

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 $254.
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 PAM Specialty Hospital of San Antonio Medical Center 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.