CMS Price Transparency Data

Prosthetic fitting and training

Facility: Chino Valley Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $43
Cash Discount Price: $42
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Chino Valley Medical Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.06x the Medicare baseline. Located in 5451 Walnut Ave, Chino, CA.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $42 (104%)

Insurance Median: $43 (106%)

Cash: $42 (104% of Medicare)

Ins. Median: $43 (106% 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
Rios	$41	101%
Alignment	$43	106%
Blue Shield Of Ca Triwest Healthcare Ccn	$43	106%
Brand New Day	$43 - $64	106%
Central Health Plan	$43	106%
Choice Physicians Network	$43	106%
Citrus Valley Physicians Group	$43	106%
Emanate Health	$43 - $86	106%
Epic Health Plan	$43	106%
Health Net Of Ca	$43 - $63	106%
Inland Empire Foundation For Medical Care	$43	106%
Inland Empire Health Plan	$43 - $54	106%
Medicare (plans)	$43	106%
Molina	$43	106%
Prime Healthcare Services	$43	106%
Renal Payer Solutions	$43	106%
Tricare	$43	106%
Vantage Care	$43	106%
Neighborhood	$44	109%
Imperial Health Plan Of Ca	$45	111%
Health Net Federal Services Cdcr	$54	134%
Aetna	$55	136%
Worker Compensation	$57	141%
Employer Direct Healthcare	$60	148%
Naphcare	$67	166%

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 $42.
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 Chino Valley Medical Center 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.