CMS Price Transparency Data

Prosthetic fitting and training

Facility: PAM Rehabilitation Hospital of Beaumont

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $64
Cash Discount Price: $85
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at PAM Rehabilitation Hospital of Beaumont is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.58x the Medicare baseline. Located in 3340 Plaza 10 Drive, Beaumont, TX.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $85 (210%)

Insurance Median: $64 (158%)

Cash: $85 (210% of Medicare)

Ins. Median: $64 (158% 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	$8 - $26	20%
Curative	$29	72%
Christus Health Plan	$34	84%
Imperial Insurance Of Texas	$34	84%
Caresource	$40	99%
Ninety Degree Benefits	$42	104%
Blue Cross Blue Shield	$45	111%
Healthcare Highways	$47	116%
Ilumed Aco Reach	$55	136%
America'S Choice Provider Network	$59	146%
Provider Network Of America	$64	158%
Quik Trip	$64	158%
Usa Managed Care Organization	$64	158%
Velocity Provider Ppo Network	$64	158%
Multiplan/Phcs	$68	168%
Cigna	$70 - $115	173%
Memorial Hermann Health Plan	$70	173%
Prime Health Services	$72	178%
Select Care	$90	223%
Today'S Option	$90	223%

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 $85.
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 PAM Rehabilitation Hospital of Beaumont 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.