CMS Price Transparency Data
Prosthetic fitting and training
Facility: Mercy Hospital Fort Smith
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $47
- Cash Discount Price: $57
- vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Mercy Hospital Fort Smith is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.16x the Medicare baseline. Located in 7301 Rogers Ave, Fort Smith, AR.
Cash / Self-Pay
$57
Average discount available for prompt cash payment at this facility.
Insurance Median
$47
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: $57 (141%)
Insurance Median: $47 (116%)
Cash: $57 (141% of Medicare)
Ins. Median: $47 (116% 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 |
|---|---|---|
| Mercy Interfacility [20513] | $17 - $21 | 42% |
| Aither Health Contracted [320449] | $31 - $38 | 77% |
| Edison Health Solutions Contracted [320502] | $31 - $38 | 77% |
| Mercy Benefit Admin Contracted [320251] | $31 - $58 | 77% |
| Medicaid / KanCare | $35 - $54 | 87% |
| Aetna | $36 - $77 | 89% |
| American Health Advantage Of Mo Mcr [20264] | $36 | 89% |
| Blue Cross Blue Shield | $36 - $47 | 89% |
| Cherokee Nation Health Serv Contracted [320066] | $36 | 89% |
| Cross Timbers Hospice [20098] | $36 | 89% |
| Dept Of Veteran Affairs Contracted [320106] | $36 | 89% |
| Elara Caring Aspire Hospice Contracted [320433] | $36 | 89% |
| Elara Caring Aspire Hospice [20433] | $36 | 89% |
| Globalhealth Contracted [320145] | $36 | 89% |
| Halo Hcr Inc Hospice Contracted [320432] | $36 | 89% |
| Halo Hcr Inc Hospice [20432] | $36 | 89% |
| Humana | $36 - $77 | 89% |
| Independent Health [20197] | $36 | 89% |
| Jordan Valley Senior Care Pace [20515] | $36 | 89% |
| Kindful Hospice Contracted [320434] | $36 | 89% |
| Kindful Hospice [20434] | $36 | 89% |
| Medical Associates Health [20444] | $36 | 89% |
| Medicare (plans) | $36 - $38 | 89% |
| Mercy Hospice Okc [20252] | $36 | 89% |
| Pace Of The Ozarks [20518] | $36 | 89% |
| Provider Partners Health Plans Contracted [320450] | $36 | 89% |
| Qual Choice Contracted [320325] | $36 | 89% |
| Spina Bifida Hlthcare Benefit [20506] | $36 | 89% |
| Tribute Health Plan Mcr [20338] | $36 | 89% |
| Tricare | $36 | 89% |
| UnitedHealthcare | $36 - $186 | 89% |
| Valir Pace [20503] | $36 | 89% |
| Wellfirst Health Mcr [20443] | $36 | 89% |
| Cigna | $38 - $168 | 94% |
| 90 Degree Benefits Contracted [320436] | $39 - $48 | 97% |
| Show-Me Health Administrators Contracted [320483] | $39 - $48 | 97% |
| Auxiant Contracted [320462] | $47 - $62 | 116% |
| Ebms Contracted [320493] | $47 - $58 | 116% |
| Healthlink Contracted [320179] | $47 - $62 | 116% |
| Imagine 360 Contracted [320494] | $47 - $58 | 116% |
| Municipal Health Plan Contracted [320271] | $47 - $58 | 116% |
| Reflect Health Contracted [320492] | $47 - $58 | 116% |
| Usable Contracted [320409] | $47 | 116% |
| Insurance System Inc Contracted [320465] | $51 - $62 | 126% |
| Personify Health Contracted [320051] | $51 - $62 | 126% |
| Preferred Health Plan Contracted [320522] | $51 - $62 | 126% |
| Workers Comp [20426] | $51 - $62 | 126% |
| Ambetter / Centene | $54 | 134% |
| Home State Health Plan Contracted [320187] | $54 | 134% |
| Novasys Contracted [320285] | $54 - $140 | 134% |
| Health Choice Contracted [320166] | $58 | 144% |
| Ppo Plus Contracted [320310] | $58 - $72 | 144% |
| First Health Contracted [320128] | $60 - $74 | 148% |
| Employers Health Coalition Contracted [320116] | $61 - $75 | 151% |
| Private Health Care Systems Contracted [320320] | $62 - $77 | 153% |
| Private Health Care Systems [20320] | $62 - $77 | 153% |
| Multiplan Contracted [320270] | $66 - $82 | 163% |
| Multiplan [20270] | $66 - $82 | 163% |
| Qual Choice Contracted [320324] | $99 | 245% |
| United Medical Resources Contracted [320454] | $186 | 460% |