CMS Price Transparency Data

Prosthetic fitting and training

Facility: Baylor Scott & White Hospital Brenham

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $119
Cash Discount Price: $128
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Baylor Scott & White Hospital Brenham is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.94x the Medicare baseline. Located in 700 Medical Parkway, Brenham, TX.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $128 (317%)

Insurance Median: $119 (294%)

Cash: $128 (317% of Medicare)

Ins. Median: $119 (294% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 294% of the Medicare baseline (a markup of 194%). 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
Baylor Scott & White Health Plan	$26 - $91	64%
Triwest	$28	69%
American Health Plan	$29	72%
Blue Cross Blue Shield	$29 - $145	72%
Corvel	$29	72%
Healthspring	$29	72%
Prime Health Services	$29	72%
Procare Advantage	$29	72%
Superior Health Plan	$29	72%
Careworks Fka Rockport	$34	84%
Injury Management Organization	$34	84%
Sedgwick	$34	84%
UnitedHealthcare	$88	218%
Aetna	$117	290%
Midcoast	$117	290%
Quiktrip	$117	290%
University Of Mary Hardin-Baylor	$123	304%
Independent Medical System	$128	317%
Imagine Health	$133	329%
Curative	$138	341%
Cigna	$149 - $185	369%
First Health	$149	369%
Healthsmart	$149 - $160	369%
Humana	$149 - $170	369%
Private Health Care System	$160	396%
Bluebell Creameries	$191	473%

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 $128.
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 Baylor Scott & White Hospital Brenham 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.