CMS Price Transparency Data
Prosthetic fitting and training
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $64
- Cash Discount Price: $139
- vs. Medicare Baseline: 1.58x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at AHMC Anaheim Regional Medical Center is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.58x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$139
Average discount available for prompt cash payment at this facility.
Insurance Median
$64
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: $139 (344%)
Insurance Median: $64 (158%)
Cash: $139 (344% of Medicare)
Ins. Median: $64 (158% 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
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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 |
|---|---|---|
| Netcare Life And Health Insurance | $30 - $40 | 74% |
| Veterans Administration | $32 | 79% |
| Advance Clinical Research Institute | $35 - $48 | 87% |
| Ahmc Reciprocity Agreement | $35 - $48 | 87% |
| Health Net | $36 | 89% |
| Prospect Medical Group | $41 | 101% |
| Alta Los Angeles Hospital | $42 | 104% |
| Prospect Health Plan | $42 - $61 | 104% |
| Tricare | $43 | 106% |
| Aetna | $45 - $83 | 111% |
| Affiliated Doctors Of Orange County | $45 | 111% |
| Aids Health Foundation | $45 | 111% |
| Alignment Health Plan | $45 | 111% |
| Allied Physicians | $45 - $68 | 111% |
| Altamed Health Network | $45 | 111% |
| Apa Aco Inc | $45 | 111% |
| Avanti | $45 - $54 | 111% |
| Beverly Hospital | $45 - $50 | 111% |
| Blue Cross Blue Shield | $45 - $91 | 111% |
| Blue Shield Of California | $45 - $355 | 111% |
| Brand New Day | $45 - $57 | 111% |
| California Health Plan | $45 | 111% |
| Caloptima | $45 | 111% |
| Central Health Of California | $45 | 111% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $45 | 111% |
| Davita Heatlhcare Partners Plan Inc | $45 - $86 | 111% |
| Emanate Health | $45 - $57 | 111% |
| Healthcare Partners | $45 | 111% |
| Healthnet | $45 | 111% |
| Heritage Provider Network | $45 - $61 | 111% |
| Humana | $45 | 111% |
| Innovative Integrated Health (Iih)/Orange County Pace | $45 | 111% |
| Kaiser Foundation Hospitals | $45 | 111% |
| Medicare (plans) | $45 - $80 | 111% |
| Monarch Health Plan | $45 - $108 | 111% |
| Monarch Healthcare Medical Group | $45 | 111% |
| Pacificare | $45 | 111% |
| Private Pay Flat Rate | $45 | 111% |
| Scan Health Plan | $45 | 111% |
| Self-Pay | $45 | 111% |
| Seoul Medical Group | $45 | 111% |
| Wellcare | $45 | 111% |
| Align Senior Care | $47 | 116% |
| Medical Acquisition Company | $47 - $64 | 116% |
| Nchp | $47 | 116% |
| Talbert Medical Group | $55 | 136% |
| Ahmc Health Self-Insurance Epo | $57 | 141% |
| Knox-Keene Act | $57 | 141% |
| Healthcare Partners Commercial | $64 - $86 | 158% |
| Huntington Memorial Hospital | $64 - $86 | 158% |
| Genesis Healthcare Ipa Ancillary | $71 - $95 | 176% |
| Msi/Medical Services For Indigents | $75 | 186% |
| Affiliated Health Fund | $83 - $111 | 205% |
| Allnet Preferred Provider | $83 - $111 | 205% |
| Care First | $83 - $111 | 205% |
| Interplan | $83 - $111 | 205% |
| Orange County Preferred Provider Organization | $83 - $119 | 205% |
| Private Healthcare Systems | $83 - $111 | 205% |
| Capp Care | $88 - $119 | 218% |
| Choicecare | $88 - $119 | 218% |
| Corvel | $88 - $119 | 218% |
| Multiplan Inc | $88 - $119 | 218% |
| Health Net Inc | $91 - $153 | 225% |
| National Provider Network | $94 - $127 | 233% |
| Three Rivers Providers Network | $94 - $127 | 233% |
| First Health | $100 - $135 | 247% |
| Memorial Healthcare Ipa | $100 | 247% |
| Health Payors Organization | $106 - $143 | 262% |
| Non Contracted Commercial | $118 - $159 | 292% |
| UnitedHealthcare | $198 - $344 | 490% |
| Cigna | $530 | 1312% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $1,403 | 3472% |