CMS Price Transparency Data

Prosthetic fitting and training

Facility: Methodist McKinney Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $52
Cash Discount Price: $94
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Methodist McKinney Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.29x the Medicare baseline. Located in 8000 W Eldorado Pkwy Bldg C Suite C, McKinney, TX.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $94 (233%)

Insurance Median: $52 (129%)

Cash: $94 (233% of Medicare)

Ins. Median: $52 (129% 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	$41 - $119	101%
Blue Cross Blue Shield	$41 - $98	101%
Medicare (plans)	$41 - $43	101%
UnitedHealthcare	$41 - $43	101%
Ust Health Proof [1005]	$41	101%
Wellcare [7016]	$41	101%
American Health Advantage Of Texas [7099]	$43	106%
Cigna	$43	106%
Globalhealth [1003]	$43	106%
Humana	$43	106%
Procare Advantage [7018]	$43	106%
Southwestern Health Resources Swhr [7015]	$43	106%
Provider Partners Health Plan [7025]	$45	111%
Alternative Service Concepts [8005]	$51	126%
Oscar Insurance Company [2057]	$53	131%
Bright Healthcare [2222]	$57	141%
Molina [3017]	$59	146%
Wellpoint Marketplace Exchange [3071]	$63	156%
90 Degree Benefit [3057]	$67	166%
Allied National [2031]	$67	166%
Entrust/90 Degree [2058]	$67	166%
Ambetter / Centene	$69	171%
Friday Health Plan [2061]	$69	171%
Imperial Insurance Companies [3073]	$73	181%
Evry Health [1013]	$81	200%
Sana Benefits [3069]	$81	200%
Velocity [3070]	$81	200%
Web Tpa [3049]	$107 - $119	265%

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 $94.
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 Methodist McKinney Hospital 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.