CMS Price Transparency Data

Prosthetic fitting and training

Facility: Grandview Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $53
  • Cash Discount Price: $22
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Grandview Medical Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.31x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$22

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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: $22 (54%)
Insurance Median: $53 (131%)
Cash: $22 (54% of Medicare)
Ins. Median: $53 (131% 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.

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
Self Pay $17 - $27 42%
Bp Health Advocate $28 69%
Tricare $35 87%
Blue Advantage $37 92%
Cigna $37 - $171 92%
Hospice $37 92%
Humana $37 92%
Medicare (plans) $37 92%
Node Champva $37 92%
Node Devoted Health Mcr Adv $37 92%
Node Va $37 92%
Select Health $37 92%
UnitedHealthcare $37 - $217 92%
Veterans Eval Services $37 92%
Victory Health $37 92%
Viva Health $37 - $191 92%
Aetna $38 94%
Node Clover Health Mcr Adv $38 94%
Node Wellcare Mcr Adv $38 94%
Ag Administrators $39 97%
Choicecare $39 97%
Drummond $39 97%
Alamed $41 101%
American Employee Alliance $44 109%
First Health $47 - $67 116%
Novanet $49 121%
Ambetter / Centene $56 139%
Healthchoice $56 - $67 139%
Value Options $56 139%
Node Us Dept Of Labor $59 146%
Healthspring $65 161%
Blue Cross Blue Shield $67 166%
Multiplan $68 - $78 168%
Blue Bell Creameries $78 193%
Natl Comp Care $83 205%
Usa Ppo $83 205%
Coventry Work Comp Al $87 215%
Alabama Wc $94 233%
Cal-Med $94 233%
Corvel $94 233%
Associated Admin $100 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals