CMS Price Transparency Data

Prosthetic fitting and training

Facility: Riverview Regional Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $58
Cash Discount Price: $37
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Riverview Regional Medical Center is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.44x the Medicare baseline. Located in 600 South Third Street, Gadsden, AL.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $37 (92%)

Insurance Median: $58 (144%)

Cash: $37 (92% of Medicare)

Ins. Median: $58 (144% 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	$35	87%
Blue Cross Blue Shield	$37 - $49	92%
Cigna	$37	92%
Evernorth Behavioral Health	$37	92%
Health Service Center	$37	92%
Medicare (plans)	$37	92%
Tricare	$37	92%
UnitedHealthcare	$37 - $113	92%
Viva Health	$37	92%
Devoted Health	$38	94%
Simpra Advantage	$38	94%
Employer Direct Healthcare	$52	129%
Compone	$58	144%
Naphcare	$58	144%
Corvel	$59	146%
Novanet	$61	151%
Zelis(Fka Stratose)	$61	151%
Americas Choice Provider Network	$62	153%
Multiplan	$62	153%
Occunet	$62 - $75	153%
Prime Health Services	$62	153%
Three Rivers	$62	153%
Provider Select	$63	156%
Provider Network Of America	$64	158%
Workers Compensation	$64	158%

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 $37.
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 Riverview Regional Medical Center 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.