CMS Price Transparency Data

Prosthetic fitting and training

Facility: Adventist Health White Memorial Montebello

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $64
Cash Discount Price: $46
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Adventist Health White Memorial Montebello is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.58x the Medicare baseline. Located in 309 W Beverly Blvd, Montebello, CA.

Cash / Self-Pay

$46

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: $46 (114%)

Insurance Median: $64 (158%)

Cash: $46 (114% 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

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
Blue Shield Epn Ifp	$38	94%
Aetna	$46 - $65	114%
Alignment Health Plan-All Plans	$46	114%
Altamed Mcare-All Other Plans	$46	114%
Blue Shield Mcare Adv	$46	114%
Brand New Day Mcare-All Other Plans	$46	114%
Brandman Health Plan-All Plans	$46	114%
Caremore-All Plans	$46	114%
Clever Care Hp-All Plans	$46	114%
Easy Choice Mcare Adv-All Plans	$46	114%
Healthnet Med Adv	$46	114%
Kaiser Mcare Adv	$46	114%
Scan Health-All Plans	$46	114%
Oscar-All Plans	$48	119%
Healthnet Salud	$53	131%
Healthnet Comm-All Other Plans	$64	158%
Cigna	$85	210%
Altamed Mcal	$120	297%
Bc Mcal	$120	297%
Blue Shield Promise Mcal	$120	297%
Brand New Day Mcal	$120	297%
Healthnet Mcal	$120	297%
Kaiser Mcal	$120	297%
La Care Mcal	$120	297%
Medi-Cal	$120	297%
Molina Mcal - All Plans	$120	297%
Blue Cross Blue Shield	$147	364%
Healthcare Partners-All Plans	$160	396%
UnitedHealthcare	$181	448%
Blue Shield Epn Core	$209	517%
Blue Shield Comm - All Other Plans	$217	537%

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 $46.
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 Adventist Health White Memorial Montebello 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.