Prosthetic fitting and training
Facility: Watsonville Community Hospital
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $215
- Cash Discount Price: $205
- vs. Medicare Baseline: 5.32x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 532% of the Medicare baseline (a markup of 432%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ace-Usa | $46 | 114% |
| Alignment Health Plan | $46 | 114% |
| Beta Healthcare Group | $46 | 114% |
| Blue Shield Ppo | $46 | 114% |
| Crawford & Co | $46 | 114% |
| Fireman'S Fund Work Comp | $46 | 114% |
| Fleming & Associates | $46 | 114% |
| Gallagher Bassett Svcs | $46 | 114% |
| Hartford Workers' Comp | $46 | 114% |
| Health Net Of California | $46 - $215 | 114% |
| Keenan & Assoc Work Comp | $46 | 114% |
| Kemper Group Workers Comp | $46 | 114% |
| Liberty Mutual Work Comp | $46 | 114% |
| Medicare (plans) | $46 | 114% |
| Miscellaneous Work Comp | $46 | 114% |
| Pinnacle Healthcare Uc | $46 | 114% |
| Republic Idemnity W/Comp | $46 | 114% |
| Secure Horizons | $46 | 114% |
| Secure Horizons Dign Hmo | $46 - $68 | 114% |
| Travelers Insurance | $46 - $342 | 114% |
| Tricare | $46 | 114% |
| U.S. Dept. Of Labor | $46 | 114% |
| UnitedHealthcare | $46 - $205 | 114% |
| Veterans Administration | $46 | 114% |
| Western Growers Work Comp | $46 | 114% |
| Workers Comp | $46 | 114% |
| Medicruz | $62 | 153% |
| Victim Compensation Plan | $62 - $342 | 153% |
| Aetna | $68 - $281 | 168% |
| Blue Cross Blue Shield | $68 - $305 | 168% |
| Blue Shield Hmo | $68 | 168% |
| Cigna | $68 - $240 | 168% |
| Great-West/Phcs | $68 - $240 | 168% |
| Health Net Pmg Hmo | $68 - $215 | 168% |
| Pacificare Hmo | $68 - $205 | 168% |
| Pinnacle Claims Tpa/Bc | $137 - $305 | 339% |
| Western Growers Trust/Bc | $137 - $305 | 339% |
| Kaiser Northern | $150 | 371% |
| Western Health Advantage | $171 | 423% |
| Health Net Smartcare Netw | $205 | 507% |
| Pacificare Ppo | $205 | 507% |
| Self Pay | $205 | 507% |
| Health Net Blue And Gold | $215 | 532% |
| Health Net Canopycare Hmo | $215 | 532% |
| Adventist Risk Management | $240 - $274 | 594% |
| First Health | $240 - $274 | 594% |
| Geha (Ccn) | $240 - $274 | 594% |
| Transwestern | $240 - $274 | 594% |
| Multiplan Inc Ppo | $267 | 661% |
| Private Healthcare System | $267 | 661% |
| Coastal Healthcare Admin | $291 - $308 | 720% |
| Salinas Valley Mem Hops | $291 | 720% |
| Calif Ironworkers Field | $297 - $305 | 735% |
| Carpenters H&W Trust | $297 - $305 | 735% |
| City Of Wats/Pinnacle Clm | $297 - $305 | 735% |
| Claims Management Wc | $297 - $305 | 735% |
| Delta Health Systems | $297 - $305 | 735% |
| Laborers Health & Welfare | $297 - $305 | 735% |
| Monterey Bay Pub Emp Trst | $297 - $305 | 735% |
| Operating Engineers | $297 - $305 | 735% |
| Robert Kennedy/Ccn | $297 - $305 | 735% |
| Sheet Metal Workers | $297 - $305 | 735% |
| State Compensation Fund | $297 - $305 | 735% |
| Teamsters Benefit Trust | $297 - $305 | 735% |
| Aaa | $342 | 846% |
| Aarp | $342 | 846% |
| Allstate | $342 | 846% |
| Apwu Health Plan | $342 | 846% |
| Bankers Life & Casualty | $342 | 846% |
| Farmers Insurance | $342 | 846% |
| Humana | $342 | 846% |
| Miscellaneous Auto | $342 | 846% |
| Miscellaneous Insurance | $342 | 846% |
| North Calif Bakery Driver | $342 | 846% |
| Physicians Mutual | $342 | 846% |
| Prucare Pmg Hmo | $342 | 846% |
| Prucare Pmg Pos | $342 | 846% |
| State Farm Ins | $342 | 846% |
| Sutter Health Plus | $342 | 846% |
| United Administrative | $342 | 846% |
| Well Path | $342 | 846% |
| Wholesale Beer Distributo | $342 | 846% |
| Zenith National Ins | $342 | 846% |