CMS Price Transparency Data

Orthotic fitting and training

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $155
Cash Discount Price: $143
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Baylor Scott & White Medical Center - Marble Falls is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.36x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $143 (310%)

Insurance Median: $155 (336%)

Cash: $143 (310% of Medicare)

Ins. Median: $155 (336% 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 336% of the Medicare baseline (a markup of 236%). 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
Superior Health Plan	$43	93%
Baylor Scott & White Health Plan	$87 - $102	189%
UnitedHealthcare	$88	191%
Aetna	$131	284%
Midcoast	$131	284%
Quiktrip	$131	284%
Blue Cross Blue Shield	$138 - $168	299%
University Of Mary Hardin-Baylor	$138	299%
Independent Medical System	$143	310%
Cigna	$149 - $185	323%
Curative	$155	336%
Humana	$155 - $167	336%
First Health	$167	362%
Healthsmart	$167 - $178	362%
Bluebell Creameries	$178	386%
Private Health Care System	$178	386%
Triwest	$178	386%
Three Rivers	$214	464%

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 $143.
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 Baylor Scott & White Medical Center - Marble Falls 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.