CMS Price Transparency Data

Orthotic fitting and training

Facility: Texas Health Presbyterian Hospital Rockwall

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $135
  • Cash Discount Price: $126
  • vs. Medicare Baseline: 2.93x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Texas Health Presbyterian Hospital Rockwall is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.93x the Medicare baseline. Located in 3150 Horizon Road, Rockwall, TX.
Cash / Self-Pay
$126

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $126 (273%)
Insurance Median: $135 (293%)
Cash: $126 (273% of Medicare)
Ins. Median: $135 (293% 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 293% of the Medicare baseline (a markup of 193%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Amerigroup $20 - $47 43%
Blue Cross Blue Shield $20 - $400 43%
Parkland $20 43%
UnitedHealthcare $20 - $401 43%
Molina $21 - $47 46%
Superior Wellcare $21 - $49 46%
American Health $45 98%
Healthspring $45 98%
Humana $46 100%
Aetna $84 - $150 182%
City Of Fort Worth $96 - $100 208%
Quick Trip $123 - $135 267%
Fort Worth Firefighters $125 - $250 271%
Phcs $143 - $159 310%
Healthsmart $154 - $179 334%
Multiplan $179 - $186 388%
Galaxy $181 - $188 393%
Usa $181 - $188 393%
Cigna $193 - $396 419%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3150 Horizon Road, Rockwall, TX 75032
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals