CMS Price Transparency Data

Orthotic fitting and training

Facility: PAM Specialty Hospital of San Antonio

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $85
  • Cash Discount Price: $110
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at PAM Specialty Hospital of San Antonio is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.84x the Medicare baseline. Located in 5418 N Loop 1604 W, San Antonio, TX.
Cash / Self-Pay
$110

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $110 (239%)
Insurance Median: $85 (184%)
Cash: $110 (239% of Medicare)
Ins. Median: $85 (184% 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
America'S Choice $77 167%
Provider Network Of America $83 180%
Quik Trip $83 180%
Usa Managed Care Organization $83 180%
Velocity Provider Ppo Network $83 180%
Evolutions Healthcare System $88 191%
Multiplan/Phcs $88 191%
Fortified Provider Network $94 204%
Prime Health Services $94 204%
Medincrease $99 215%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5418 N Loop 1604 W, San Antonio, TX 78249
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL