Prosthetic fitting and training
Facility: Whittier Hospital Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $92
- Cash Discount Price: $25
- vs. Medicare Baseline: 2.28x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Blue Cross Blue Shield | $5 - $293 | 12% |
| Physicians Healthways Medical Corporation | $11 | 27% |
| Physician Healthways | $12 - $30 | 30% |
| Applecare Medical Group | $30 | 74% |
| Veterans Administration | $32 | 79% |
| Ahmc Reciprocity | $37 - $91 | 92% |
| Ahmc Reciprocity Agreement Senior/Commercial | $37 - $91 | 92% |
| Wear And Wood | $37 - $121 | 92% |
| Aetna | $45 - $221 | 111% |
| Aids Healthcare Foundation | $45 | 111% |
| Alignment Health Plan | $45 | 111% |
| Allied Physicians | $45 - $68 | 111% |
| Alta Los Angeles Hospitals Inc | $45 | 111% |
| Alta Med Health Network | $45 | 111% |
| Apa/Aco Inc | $45 | 111% |
| Avanti | $45 - $54 | 111% |
| Beverly Hospital | $45 - $50 | 111% |
| Blue Shield Of California | $45 - $433 | 111% |
| Brand New Day | $45 - $56 | 111% |
| Caloptima | $45 | 111% |
| Caremore | $45 | 111% |
| Central Health Plan | $45 | 111% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $45 | 111% |
| Easy Choice Health Plan | $45 | 111% |
| Emanate Health | $45 - $56 | 111% |
| Health Net | $45 - $181 | 111% |
| Heritage Provider Network | $45 - $61 | 111% |
| Humana | $45 | 111% |
| Kaiser Foundation | $45 - $212 | 111% |
| La Care Covered Direct | $45 | 111% |
| La Care Health Plan | $45 - $167 | 111% |
| Medicare (plans) | $45 - $47 | 111% |
| Pacific Alliance Medical Center | $45 | 111% |
| Pacificare Of California | $45 | 111% |
| Private Pay | $45 | 111% |
| Prospect Health Plan | $45 - $72 | 111% |
| Scan Health Plan | $45 | 111% |
| Self-Pay | $45 | 111% |
| Synermed | $45 | 111% |
| Tricare | $46 | 114% |
| Molina Healthcare Of California | $47 | 116% |
| Molina Medical Center | $48 - $118 | 119% |
| Central Health Plan Of California | $49 - $121 | 121% |
| San Miguel Health Plan | $50 | 124% |
| Chinatown Service Center Pace | $54 | 134% |
| Ahmc Health | $57 | 141% |
| Knox-Keene Act | $57 | 141% |
| UnitedHealthcare | $59 - $267 | 146% |
| Capnet | $60 | 148% |
| Pacific Independent Physician Association | $60 | 148% |
| Edward Medical Group | $65 | 161% |
| Prospect Medical | $68 - $167 | 168% |
| Allied Physicians Ipa | $69 | 171% |
| Care 1St Health Plan | $74 - $182 | 183% |
| New Horizon Medical Group Inc | $74 - $182 | 183% |
| Cost Containment | $80 - $197 | 198% |
| Universal Care | $80 - $212 | 198% |
| Asi/Flex | $86 - $212 | 213% |
| Us Comp Care | $86 - $212 | 213% |
| Value Healthplan Of California | $86 - $212 | 213% |
| Community Care Network | $92 - $227 | 228% |
| Coventry Health Care | $92 - $227 | 228% |
| Coventry Health Care National Network | $92 - $227 | 228% |
| Fmc Los Angeles County | $92 - $227 | 228% |
| Interplan Corporation | $92 - $227 | 228% |
| Interplan Health Group | $92 - $227 | 228% |
| Managed Care Administrators | $92 - $227 | 228% |
| Prohealth | $92 - $227 | 228% |
| Davita Healthcare Partners | $94 | 233% |
| Multiplan | $105 - $258 | 260% |
| Health Net Inc | $111 - $135 | 275% |
| Cigna | $123 - $303 | 304% |
| Commercial Non Contract | $123 - $303 | 304% |
| Medi-Cal Sub Acute | $123 - $303 | 304% |
| One Legacy | $123 - $303 | 304% |
| Healthnet | $136 - $234 | 337% |
| Great-West Healthcare Of California | $2,500 | 6187% |