CMS Price Transparency Data

Prosthetic fitting and training

Facility: Northwest Medical Center Sahuarita

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $48
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Northwest Medical Center Sahuarita is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.19x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $95 (235%)
Insurance Median: $48 (119%)
Cash: $95 (235% of Medicare)
Ins. Median: $48 (119% 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 - $111 97%
Blue Cross Blue Shield $39 - $159 97%
Cigna $39 - $300 97%
Humana $39 97%
Medicare (plans) $39 97%
Mercy Care $39 - $48 97%
Node Caremore Mcr Adv $39 97%
Node Mercy Care Mcr Adv $39 97%
UnitedHealthcare $39 - $185 97%
Department Of Veterans Affairs $40 99%
Node Champva $40 99%
Node Clover Health Mcr Adv $40 99%
Node Devoted Health Mcr Adv $40 99%
Node Non Par Hospice Agree $40 99%
Node Triwest $40 99%
Node Va $40 99%
Tricare $40 99%
Banner Mcr Adv $41 101%
Node Banner Mcr Adv $41 101%
Node Wellcare Mcr Adv $41 101%
Medicaid / KanCare $48 - $51 119%
Ambetter / Centene $56 139%
Node Health Choice Health Exchange $59 146%
Node Us Dept Of Labor $59 146%
Self Pay $60 - $129 148%
Node Fusion Network $71 176%
Node J Allen Inmate Health Svcs $75 186%
Coventry Work Comp Al $199 492%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals