CMS Price Transparency Data

Orthotic fitting and training

Facility: PAM Health Rehabilitation Hospital of Kyle

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $80
Cash Discount Price: $118
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at PAM Health Rehabilitation Hospital of Kyle is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.74x the Medicare baseline. Located in 5980 Kyle Pkwy, Kyle, TX.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $118 (256%)

Insurance Median: $80 (174%)

Cash: $118 (256% of Medicare)

Ins. Median: $80 (174% 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.

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
Whole Foods (Employers Health Network)	$24 - $30	52%
Aetna	$32 - $218	69%
Curative	$33	72%
Blue Cross Blue Shield	$42 - $65	91%
Christus Health Plan	$42 - $52	91%
Imperial Insurance Company Of Texas	$42 - $52	91%
Sendero Health Plan	$43 - $78	93%
Humana	$44 - $169	95%
Ilumed Aco Reach	$44	95%
Wellcare Complete	$44	95%
Wellmed	$44	95%
Wellpoint (Amerigroup)	$44	95%
UnitedHealthcare	$45 - $110	98%
Seton Health Plan	$53 - $65	115%
Velocity Provider Ppo Network	$53 - $97	115%
Healthcare Highways	$58 - $71	126%
Prime Health Services	$58 - $110	126%
Ninety Degree Benefits	$66	143%
Cigna	$70 - $103	152%
America'S Choice Provider	$74 - $91	161%
Oscar	$75 - $90	163%
Superior Health Plan	$75	163%
Ambetter / Centene	$80	174%
Quik Trip	$80 - $97	174%
Usa Managed Care Organization	$80 - $97	174%
Multiplan/Phcs	$85 - $104	184%
Medincrease	$95 - $116	206%
Provider Network Of America	$95 - $116	206%
Baylor Scott And White Health Plan	$120	260%

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 $118.
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 Health Rehabilitation Hospital of Kyle 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.