CMS Price Transparency Data

Orthotic fitting and training

Facility: PAM Rehabilitation Hospital of Allen

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $98
Cash Discount Price: $177
vs. Medicare Baseline: 2.13x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at PAM Rehabilitation Hospital of Allen is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.13x the Medicare baseline. Located in 1001 Raintree Circle, Allen, TX.

Cash / Self-Pay

$177

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $177 (384%)

Insurance Median: $98 (213%)

Cash: $177 (384% of Medicare)

Ins. Median: $98 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
Aetna	$23 - $48	50%
Southwestern Accountable Care	$35	76%
Curative	$46 - $95	100%
Imperial Insurance Of Texas	$46 - $95	100%
Ninety Degree Benefits	$58 - $119	126%
Healthcare Highways	$64 - $131	139%
Cigna	$70 - $115	152%
America'S Choice Provider Network	$81 - $166	176%
Provider Network Of America	$87 - $178	189%
Quik Trip	$87 - $178	189%
Usa Managed Care Organization	$87 - $178	189%
Velocity Provider Ppo Network	$87 - $178	189%
Multiplan/Phcs	$93 - $190	202%
Ambetter / Centene	$95	206%
Prime Health Services	$98 - $202	213%
Medincrease	$104 - $214	226%

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 $177.
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 PAM Rehabilitation Hospital of Allen 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.