CMS Price Transparency Data

Prosthetic fitting and training

Facility: Adventist Health Delano

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $99
Cash Discount Price: $28
vs. Medicare Baseline: 2.45x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Adventist Health Delano is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.45x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $28 (69%)

Insurance Median: $99 (245%)

Cash: $28 (69% of Medicare)

Ins. Median: $99 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Blue Shield Epn - All Other Plans	$31	77%
Bakersfield Fam Med Grp-All Plans	$43	106%
Healthnet Mcr Adv	$43	106%
Kern Mcr Adv Dual Dnsp-All Other Plans	$43	106%
Medicare (plans)	$43 - $69	106%
Tricare	$43	106%
UnitedHealthcare	$43 - $101	106%
Universal Care Mcr- All Other Plans	$43	106%
Kaiser Comm Ip/Op Only- All Other Plans	$74	183%
Healthnet- All Other Plans	$75	186%
Ah Employee Health Plan - All Plans	$77	191%
Coventry- All Plans	$85	210%
Centivo - All Plans	$96	238%
County Of Kern Network - All Plans	$99	245%
Gem Care- All Plans	$99	245%
Aetna	$104	257%
Foundation For Medical Care Of Kern County - All P	$106	262%
Cigna	$113	280%
Western Growers - All Plans	$114	282%
Blue Cross Blue Shield	$117	290%
Dignty Hlth Mcal Op Only	$141	349%
Kaiser Medi-Cal Ip/Op Only	$141	349%
Medi-Cal	$141	349%
Universal Care Mcal	$141	349%
Healthnet Medi-Cal	$168	416%
Kern Health System Mcal	$182	450%
Blue Shield Non-Epn	$262	648%

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 $28.
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 Delano 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.