CMS Price Transparency Data

Prosthetic fitting and training

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $117
Cash Discount Price: $132
vs. Medicare Baseline: 2.90x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Sharp Coronado Hospital and Hlthcr Ctr is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.90x the Medicare baseline. Located in 250 Prospect Place, Coronado, CA.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $132 (327%)

Insurance Median: $117 (290%)

Cash: $132 (327% of Medicare)

Ins. Median: $117 (290% 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 290% of the Medicare baseline (a markup of 190%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Community Health Group	$16	40%
Indian Health Council	$26	64%
Health Net	$52 - $158	129%
UnitedHealthcare	$52 - $119	129%
San Diego Pace	$53 - $123	131%
Blue Shield	$54 - $121	134%
Multiplan	$60 - $98	148%
Medicare (plans)	$70 - $117	173%
Molina	$70 - $172	173%
Medi-Cal	$88	218%
Cigna	$97 - $112	240%
Aetna	$98 - $136	243%
Interplan	$98 - $158	243%
California Health And Wellness	$112 - $132	277%
Epic Americas	$112 - $123	277%
Managed Health Network	$117 - $120	290%
Blue Cross Blue Shield	$121 - $136	299%
Humana	$123 - $132	304%
County Medical Services	$132	327%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $132.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97761.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sharp Coronado Hospital and Hlthcr Ctr is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97761.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.