CMS Price Transparency Data

Prosthetic fitting and training

Facility: Northwest Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $60
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Northwest Medical Center is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.48x the Medicare baseline. Located in 6200 North La Cholla Boulevard, Tucson, AZ.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $100 (247%)
Insurance Median: $60 (148%)
Cash: $100 (247% of Medicare)
Ins. Median: $60 (148% 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
Aetna $39 - $149 97%
Cigna $39 - $300 97%
Humana $39 97%
Medicare (plans) $39 97%
Node Caremore Mcr Adv $39 97%
Pascua Yaqui Tribe $39 97%
Scan Health Plan $39 97%
UnitedHealthcare $39 - $185 97%
Blue Cross Blue Shield $40 - $159 99%
Department Of Veterans Affairs $40 99%
Fresenius Health $40 99%
Node Clover Health Mcr Adv $40 99%
Node Devoted Health Mcr Adv $40 99%
Node Non Par Hospice Agree $40 99%
Node Va $40 99%
Tricare $40 99%
Triwest $40 99%
Veterans Eval Services $40 99%
Magellan $41 - $50 101%
Node Banner Mcr Adv $41 101%
Wellcare $41 101%
Medicaid / KanCare $48 - $51 119%
Ambetter / Centene $56 139%
Node Health Choice Health Exchange $58 144%
Health Net $63 156%
Node Us Dept Of Labor $63 156%
Node Fusion Network $71 176%
Node J Allen Inmate Health Svcs $75 186%
Self Pay $80 - $120 198%
Seven Corners $91 225%
First Health Coventry $174 431%
Coventry Medical Center $199 492%
Multiplan $276 683%
Prime Health $282 698%
Healthsmart $299 740%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 North La Cholla Boulevard, Tucson, AZ 85741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals