Prosthetic fitting and training
Facility: AHMC Seton Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $66
- Cash Discount Price: $123
- vs. Medicare Baseline: 1.63x 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.
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 |
|---|---|---|
| Self Pay | $23 - $52 | 57% |
| Veterans Administration (Va) | $36 | 89% |
| North East Medical Services | $39 - $51 | 97% |
| Aetna | $51 - $104 | 126% |
| Apcmg | $51 - $77 | 126% |
| Asian American Medical Group | $51 - $64 | 126% |
| Blue Cross Blue Shield | $51 - $117 | 126% |
| Blue Shield Of California | $51 - $214 | 126% |
| Brand New Day | $51 - $64 | 126% |
| Brown And Toland Medical Group | $51 - $64 | 126% |
| Canopy Health | $51 - $93 | 126% |
| Care Advantage | $51 | 126% |
| Chinese Community Health Plan | $51 - $77 | 126% |
| Covid-19 Uninsured Program | $51 | 126% |
| For Your Benefit | $51 | 126% |
| Healthnet Seniority | $51 | 126% |
| Humana | $51 | 126% |
| Imperial Health Plan | $51 | 126% |
| Jade Health Care Mg | $51 - $77 | 126% |
| Kaiser | $51 - $126 | 126% |
| Medicare (plans) | $51 | 126% |
| Pacificare | $51 | 126% |
| UnitedHealthcare | $51 - $648 | 126% |
| Easy Choice Hospital Services | $52 | 129% |
| Tricare | $52 | 129% |
| Hill Physicians Medical Group Inc | $53 - $61 | 131% |
| Central Health Plan | $55 | 136% |
| Ahmc Health | $64 | 158% |
| Knox-Keene Act | $64 | 158% |
| Interplan Corporation | $92 | 228% |
| Cigna | $108 | 267% |
| Healthcare Foundation Of San Mateo | $108 - $116 | 267% |
| Multiplan/Bce Emergis | $116 | 287% |
| Private Healthcare Sytems Inc | $116 | 287% |
| The First Health Network | $116 | 287% |
| Health Net | $118 | 292% |
| Beech Street Corporation | $123 | 304% |
| Choicecare Network | $131 | 324% |
| Multiplan | $131 | 324% |
| Mills Peninsula Health Services | $139 | 344% |
| Indemnity | $154 | 381% |
| Workers Compensation Federal | $154 | 381% |