CMS Price Transparency Data
Prosthetic fitting and training
Facility: Adventist Health White Memorial
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $135
- Cash Discount Price: $49
- vs. Medicare Baseline: 3.34x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Adventist Health White Memorial is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 3.34x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$49
Average discount available for prompt cash payment at this facility.
Insurance Median
$135
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: $49 (121%)
Insurance Median: $135 (334%)
Cash: $49 (121% of Medicare)
Ins. Median: $135 (334% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 334% of the Medicare baseline (a markup of 234%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Access Group | $38 | 94% |
| Ahp - All Other Plans | $38 | 94% |
| Lasalle Mg Commercial - All Other Plans | $38 | 94% |
| Access Senior - All Other Plans | $45 | 111% |
| Ahp Senior | $45 | 111% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $45 | 111% |
| Altamed Connect | $45 | 111% |
| Avanti Mcr Adv - All Other Plans | $45 | 111% |
| Brand New Day Mcare - All Plans | $45 | 111% |
| Bs Va Mcare | $45 | 111% |
| Care First Mcare - All Other Plans | $45 | 111% |
| Clever Care - All Plans | $45 | 111% |
| Fcs Ipa Mcr Advan Op/Profee Only | $45 | 111% |
| Humana | $45 | 111% |
| Lasalle Mg Senior | $45 | 111% |
| Medicare (plans) | $45 | 111% |
| Molina Mcare | $45 | 111% |
| Pacific Alliance Mcare - All Other Plans | $45 | 111% |
| Preferred Senior | $45 | 111% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $45 | 111% |
| Tricare | $45 | 111% |
| UnitedHealthcare | $45 - $188 | 111% |
| Blue Cross Blue Shield | $47 - $549 | 116% |
| Fcs Ipa Op/Profee Only - All Other Plans | $48 | 119% |
| Bright Health - All Plans | $52 | 129% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $54 | 134% |
| Preferred Commercial - All Other Plans | $54 | 134% |
| Intergrated Medical - All Plans | $59 | 146% |
| Molina Benefit Exchange - All Other Plans | $61 | 151% |
| Php-Prospect Health Plan Cap - All Plans | $68 | 168% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $80 | 198% |
| Bella Vista Medi-Cal Op/Profee Only | $80 | 198% |
| Ah Employee Health Plan - All Plans | $81 | 200% |
| Centivo - All Plans | $102 | 252% |
| Pacific Ipa - All Other Plans | $104 | 257% |
| Blue Shield Mcr Adv | $105 | 260% |
| Kaiser- All Plans | $112 | 277% |
| Cigna | $115 | 285% |
| Healthnet - All Other Plans | $123 | 304% |
| Healthnet Comm Care | $127 | 314% |
| Aetna | $133 | 329% |
| Hcpamg - All Plans | $137 | 339% |
| Healthcare Inc - All Other Plans | $150 | 371% |
| La Care Mcr Adv - All Plans | $150 | 371% |
| Caremore Mcare - All Plans | $154 | 381% |
| First Heatlh Ppo - All Plans | $158 | 391% |
| Phcs Ppo - All Plans | $177 | 438% |
| Scan Health Mcare - All Plans | $177 | 438% |
| Ahf - All Plans | $205 | 507% |
| Beech Street - All Plans | $205 | 507% |
| Interplan Ppo - All Plans | $205 | 507% |
| Corvel Corp - All Plans | $218 | 539% |
| Multiplan Ppo - All Plans | $227 | 562% |
| Healthmannet - All Plans | $232 | 574% |
| Next Inc Ppo - All Plans | $232 | 574% |
| Trpn - All Plans | $232 | 574% |
| Fpn Ppo - All Plans | $246 | 609% |
| Access Medi-Cal | $273 | 676% |
| Ahp Medi-Cal | $273 | 676% |
| Alta Los Angeles Mcal 1/1/19 | $273 | 676% |
| Avanti Mcal | $273 | 676% |
| Healthcare Inc Medi-Cal | $273 | 676% |
| Lasalle Mg Medi-Cal | $273 | 676% |
| Medi-Cal | $273 | 676% |
| Molina Medi-Cal | $273 | 676% |
| Pacific Alliance Medi-Cal | $273 | 676% |
| Pacific Ipa Medi-Cal | $273 | 676% |
| Preferred Ipa La Care Mcal Cap | $273 | 676% |
| Preferred Medi-Cal | $273 | 676% |
| Altamed Medi-Cal - All Other Plans | $314 | 777% |
| Healthnet Mcal | $325 | 804% |
| Fcs Ipa Medi-Cal Op/Profee Only | $328 | 812% |
| Preferred Healthy | $341 | 844% |
| Western Growers/Pinnacle - All Plans | $341 | 844% |
| Assoc Hispanic Physcns Mcal | $382 | 945% |
| Healthnet Mcr Adv | $418 | 1034% |
| Blue Shield Epn | $460 | 1138% |
| Blue Shield - All Other Plans | $530 | 1312% |
| Blue Shield Medi-Cal | $682 | 1688% |
| Care First Medi-Cal | $956 | 2366% |