CMS Price Transparency Data

Prosthetic fitting and training

Facility: University of Alabama Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $101
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.50x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at University of Alabama Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.50x the Medicare baseline. Located in 619 South 19Th Street, Birmingham, AL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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%)

Insurance Median: $101 (250%)

Ins. Median: $101 (250% 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 250% of the Medicare baseline (a markup of 150%). 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
Viva	$26	64%
Triwest	$38	94%
University Of Alabama	$62	153%
UnitedHealthcare	$68 - $111	168%
Aetna	$76	188%
Coventry	$81 - $101	200%
North Alabama Managed Care	$81	200%
Cigna	$84 - $95	208%
Comp One	$90	223%
Alamed	$94	233%
Construction Claims Management	$94	233%
Corvel	$100	247%
Evolutions	$100 - $112	247%
Healthcare Alliance	$100	247%
Novanet	$100 - $112	247%
Prime Health Services	$100 - $112	247%
Select Value Care	$100	247%
Starcare	$100	247%
Tethys	$100	247%
Multiplan	$102	252%
Department Of Labor	$106	262%
Geha	$106	262%
Gulf Health Plans	$106	262%
Heritage Summit Health	$106	262%
Humana	$106	262%
Mississippi Physicians	$106	262%
Phifer	$106	262%
Preferred Health Partnership	$106	262%
Southern Nuclear	$106	262%
Vantage Health Plan	$106	262%
Galaxy Health Network	$112	277%
National Provider Network	$112	277%
North Mississippi Health Link	$112	277%

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 $X.
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 University of Alabama 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.