CMS Price Transparency Data

Prosthetic fitting and training

Facility: Warm Springs Rehabilitation Hospital of San Antonio

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $80
Cash Discount Price: $113
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Warm Springs Rehabilitation Hospital of San Antonio is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.98x the Medicare baseline. Located in 5101 Medical Dr, San Antonio, TX.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $113 (280%)

Insurance Median: $80 (198%)

Cash: $113 (280% of Medicare)

Ins. Median: $80 (198% 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	$11 - $30	27%
Curative	$29	72%
Baylor Scott And White Health Plan	$39 - $120	97%
Blue Cross Blue Shield	$39 - $42	97%
Christus Health Plan	$39	97%
Ilumed Aco Reach	$39	97%
Integranet Health	$39	97%
Molina Healthcare	$39	97%
Premier Health	$39	97%
Wellmed	$39	97%
Wellpoint (Amerigroup)	$39	97%
Provider Partners Health Plan	$41	101%
Integrated Medical Solutions	$43	106%
Imperial Insurance Of Texas	$45	111%
Scan Health Plan	$45	111%
Velocity Provider Ppo Network	$47 - $85	116%
Prime Health Services	$51 - $96	126%
Ninety Degree Benefits	$56	139%
Healthcare Highways	$62	153%
Cigna	$70 - $115	173%
Humana	$70	173%
America'S Choice Provider Network	$79	195%
Community First Health Plans	$80 - $105	198%
Galaxy Health	$85	210%
Network Synergy Group	$85	210%
Provider Network Of America	$85	210%
Quik Trip	$85	210%
Usa Managed Care Organization	$85	210%
Ambetter / Centene	$90	223%
Multiplan/Phcs	$90	223%
Three Rivers	$90	223%
UnitedHealthcare	$90	223%
Medincrease	$101	250%
Independent Medical Systems	$102	252%

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 $113.
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 Warm Springs Rehabilitation Hospital of San Antonio 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.