Prosthetic fitting and training
Facility: Garfield Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $134
- Cash Discount Price: $250
- vs. Medicare Baseline: 3.32x 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 332% of the Medicare baseline (a markup of 232%). 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 |
|---|---|---|
| Associated Hispanic Phys Of So Cal | $24 - $82 | 59% |
| Care First Health Plan | $24 - $41 | 59% |
| UnitedHealthcare | $24 - $245 | 59% |
| Veterans Administration | $32 | 79% |
| Advantage Care Ipa | $45 - $409 | 111% |
| Aetna | $45 - $298 | 111% |
| Aids Health Foundation | $45 | 111% |
| Allied Physicians | $45 - $68 | 111% |
| Apa Aco Inc | $45 | 111% |
| Avanti | $45 - $54 | 111% |
| Beverly Hospital | $45 - $50 | 111% |
| Blue Cross Blue Shield | $45 - $325 | 111% |
| Blue Shield | $45 - $438 | 111% |
| Blue Shield Of California | $45 - $393 | 111% |
| Brand New Day | $45 - $57 | 111% |
| Central Health Plan | $45 - $164 | 111% |
| Cms | $45 | 111% |
| Cv-19 Hrsa Uninsured Testing And Tx | $45 | 111% |
| Easy Choice Health Plan | $45 | 111% |
| Emanate Health | $45 - $57 | 111% |
| First Health Network | $45 - $286 | 111% |
| Health Net | $45 - $222 | 111% |
| Humana | $45 | 111% |
| La Care Covered Direct | $45 | 111% |
| La Care Health Plan | $45 - $225 | 111% |
| Non-Contract Medi-Care | $45 | 111% |
| Pacific Alliance Medical Center Comm/Sr | $45 | 111% |
| Physicians Healthways Medi-Cal | $45 - $409 | 111% |
| Physicians Healthways Medical Corporation | $45 - $409 | 111% |
| Scan Health Plan Sr Hmo | $45 | 111% |
| Self-Pay | $45 | 111% |
| Ucla Impact Dept Of Uncology | $45 | 111% |
| Alignment Health Plan | $47 | 116% |
| Molina Healthcare | $47 | 116% |
| Molina Healthcare Of California | $47 - $57 | 116% |
| Inter Valley Health Plan | $48 | 119% |
| Employee Health Systems Mg | $49 - $82 | 121% |
| National Disaster Medical System | $50 | 124% |
| San Miguel Health Plan | $50 | 124% |
| Chinatown Service Center Pace | $54 | 134% |
| Ahmc Health Epo | $57 | 141% |
| Knox-Keene Act | $57 | 141% |
| Access Ipa Ancillary | $60 | 148% |
| Family Health Alliance | $60 | 148% |
| Pacific Independent Physician Association | $60 | 148% |
| Private Pay | $60 | 148% |
| Health Net Comm/Hmo | $72 - $225 | 178% |
| Health Net Inc | $73 | 181% |
| Ahmc Healthcare Inc | $74 - $123 | 183% |
| Allied Physicians Risk Pool | $86 - $143 | 213% |
| Allied Physicians Risk Pool Agreement | $86 - $143 | 213% |
| Healthnet Medi Cal Cap | $86 - $143 | 213% |
| Pipa Risk Pool Agreement | $86 - $143 | 213% |
| Molina Medical Group | $96 - $160 | 238% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $98 - $164 | 243% |
| Health Net Foundation M Cal (Family Health Alliance) | $98 - $164 | 243% |
| Phys Assoc Of San Gab Valley | $98 - $164 | 243% |
| Allied Physicians Med Grp | $122 - $204 | 302% |
| Alhambra Hospital | $147 - $245 | 364% |
| Care 1St Health Plan | $147 - $245 | 364% |
| Interplan | $147 - $307 | 364% |
| One Health Plan | $172 - $286 | 426% |
| Pacificare Ppo | $181 | 448% |
| Fmc Los Angeles Co Epo | $184 - $307 | 455% |
| Corvel Corporation | $196 - $327 | 485% |
| Americas Health Plan | $208 - $348 | 515% |
| Multiplan | $208 - $348 | 515% |
| Health Payors Organization | $220 - $368 | 544% |
| Cigna | $245 - $409 | 606% |
| East La Reg Ctr | $245 - $409 | 606% |
| Non Contract Commercial | $245 - $409 | 606% |
| One Legacy | $245 - $409 | 606% |
| Pacificare Of California Inc | $246 | 609% |