CMS Price Transparency Data

Prosthetic fitting and training

Facility: Methodist Midlothian Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $55
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Methodist Midlothian Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.36x the Medicare baseline. Located in 1201 E Highway 287, Midlothian, TX.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $112 (277%)
Insurance Median: $55 (136%)
Cash: $112 (277% of Medicare)
Ins. Median: $55 (136% 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.

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
UnitedHealthcare $38 - $43 94%
Aetna $41 - $66 101%
Blue Cross Blue Shield $41 - $43 101%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] $41 101%
Medicare (plans) $41 - $43 101%
Ust Health Proof [1005] $41 101%
Wellcare [7016] $41 101%
American Health Advantage Of Texas [7099] $43 106%
Cigna $43 - $75 106%
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%
Kempton Group Administrators, Tower Extrusions [3061] $65 161%
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%
Web Tpa [3049] $75 186%
Department Of Labor [8004] $81 200%
Evry Health [1013] $81 200%
Generic Workers Comp Tx Non Par [9010] $81 200%
Generic Workers Comp Tx Par [8002] $81 200%
Generic Workers Comp Tx Par [9011] $81 200%
Sana Benefits [3069] $81 200%
Tristar Risk Management [8006] $81 200%
Velocity [3070] $81 200%
Health Plans Inc [5017] $102 252%
Medical Cost Containment Professionals [3059] $102 252%
Dart Member Care [3039] $110 272%
Healthscope Benefits [2052] $110 272%
Healthscope Benefits [3063] $110 272%
Medicaid / KanCare $163 403%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 E Highway 287, Midlothian, TX 76065
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals