CMS Price Transparency Data

Prosthetic fitting and training

Facility: Chinese Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $276
Cash Discount Price: $315
vs. Medicare Baseline: 6.83x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Chinese Hospital is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $315. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 6.83x the Medicare baseline. Located in 845 Jackson St, San Francisco, CA.

Cash / Self-Pay

$315

Average discount available for prompt cash payment at this facility.

Insurance Median

$276

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: $315 (780%)

Insurance Median: $276 (683%)

Cash: $315 (780% of Medicare)

Ins. Median: $276 (683% 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 683% of the Medicare baseline (a markup of 583%). 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
Aetna	$51 - $180	126%
Cchp Mcr Adv	$51	126%
Jade Mcr Adv	$51	126%
Blue Cross Blue Shield	$52 - $315	129%
Jade-All Other Plans	$57	141%
On Lok Mcr Adv-All Plans	$57	141%
Blue Shield - All Other Plans	$96	238%
Health Net-All Plans	$167	413%
Cigna	$173	428%
Cchp-All Other Plans	$268	663%
Hp Of San Mateo Mcr Adv	$284	703%
Asian Medical Group Mcare Op Only-All Other Plans	$315	780%
Bay Area Accountable Care Mcare	$315	780%
Medi-Cal	$315	780%
San Francisco Health Plan- All Plans	$315	780%
Hp Of San Mateo Medi-Cal	$387	958%
Hp Of San Mateo Health Kids/Health Worx-All Other	$419	1037%
Blue Shield Medi-Cal	$425	1052%
Asian Medical Group Medi-Cal Op Only	$441	1091%
Bay Area Accountable Care - All Other Plans	$567	1403%
Jade Medi-Cal	$567	1403%

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 $315.
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 Chinese Hospital 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.