CMS Price Transparency Data

Prosthetic fitting and training

Facility: Methodist Rehabilitation Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $77
Cash Discount Price: $91
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Methodist Rehabilitation Hospital is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.91x the Medicare baseline. Located in 3020 West Wheatland Road, Dallas, TX.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

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: $91 (225%)

Insurance Median: $77 (191%)

Cash: $91 (225% of Medicare)

Ins. Median: $77 (191% 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
Humana	$54 - $109	134%
Group And Pension Administrators (Under Multiplan) (Primary)	$55 - $84	136%
Multiplan (Pchs)	$55 - $84	136%
Multiplan	$61 - $92	151%
Aetna	$72 - $109	178%
Ambetter / Centene	$72 - $109	178%
Amerigroup	$72 - $109	178%
Blue Cross Blue Shield	$72 - $109	178%
Cigna	$72 - $109	178%
Friday Health Commercial (Ppo & Epo)	$72 - $109	178%
Healthcare Highways	$72 - $109	178%
Healthscope	$72 - $109	178%
Medicare (plans)	$72 - $109	178%
Molina Exchange	$72 - $109	178%
Oscar Healthcare	$72 - $109	178%
Scott & White Health Plan	$72 - $109	178%
Southwestern Health Resources (Paid Under United Hc)	$72 - $109	178%
Superior	$72 - $109	178%
Texas Plus (Universal American)(Includes Wellcare - Merged With Texan Plus Eff 1/1/19)	$72 - $109	178%
UnitedHealthcare	$72 - $109	178%
Wellmed	$72 - $109	178%

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 $91.
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 Rehabilitation 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.