CMS Price Transparency Data

Orthotic fitting and training

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $494
Cash Discount Price: $586
vs. Medicare Baseline: 10.72x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Texas Childrens Hospital North Austin Campus is $494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $586. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 10.72x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$586

Average discount available for prompt cash payment at this facility.

Insurance Median

$494

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: $586 (1271%)

Insurance Median: $494 (1072%)

Cash: $586 (1271% of Medicare)

Ins. Median: $494 (1072% 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 1072% of the Medicare baseline (a markup of 972%). 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
First Care Health Plan	$35 - $2,257	76%
UnitedHealthcare	$35 - $2,257	76%
Driscoll Children'S Health Plan Mcd	$39 - $1,058	85%
Molina Mcd	$39 - $1,058	85%
Blue Cross Blue Shield	$46 - $2,221	100%
Community Health Choice	$46 - $2,257	100%
Community First Health Plan Mcd	$52 - $1,410	113%
Cook Children'S Health Plan	$52 - $1,410	113%
Cigna	$74 - $2,257	161%
Aetna	$83 - $2,257	180%
Kelseycare	$84 - $2,292	182%
Healthsmart	$91 - $2,468	197%
Evolutions Healthcare	$98 - $2,644	213%
First Health	$114 - $3,350	247%
Multiplan	$117 - $3,173	254%
Galaxy Health Network	$124 - $3,350	269%

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 $586.
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 Texas Childrens Hospital North Austin Campus 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.