CMS Price Transparency Data
Prosthetic fitting and training
Facility: Coastal Communities Hospital
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $53
- Cash Discount Price: $88
- vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Coastal Communities Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.31x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$88
Average discount available for prompt cash payment at this facility.
Insurance Median
$53
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: $88 (218%)
Insurance Median: $53 (131%)
Cash: $88 (218% of Medicare)
Ins. Median: $53 (131% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Altamed Health Services | $26 - $45 | 64% |
| Ihhi Reciprocity | $26 | 64% |
| Kpc Healthcare Inc | $26 - $57 | 64% |
| Altamed Mcal Hmo (Ancillary) | $31 | 77% |
| Velocity National Provider Network Wc | $40 | 99% |
| Champus | $43 | 106% |
| Blue Shield | $45 - $172 | 111% |
| Caloptima | $45 | 111% |
| Central Health Plan Of California | $45 | 111% |
| Champion Health Plan | $45 | 111% |
| Choice Physicians Network | $45 | 111% |
| Citizens Choice Health Plan | $45 | 111% |
| Clever Care Health Plan | $45 | 111% |
| Easy Choice Health Plan | $45 | 111% |
| For Your Benefit | $45 | 111% |
| Health Net | $45 - $78 | 111% |
| Healthcare Partners Sr Hmo | $45 | 111% |
| Heritage | $45 | 111% |
| Hollywood Presbyterian | $45 | 111% |
| Humana | $45 | 111% |
| Imperial Health Plan Of Ca | $45 | 111% |
| Innovative Integrated Health | $45 | 111% |
| Kaiser | $45 - $54 | 111% |
| Medcare Partners | $45 | 111% |
| Monarch | $45 - $167 | 111% |
| Onecare | $45 | 111% |
| Onecare Connect | $45 | 111% |
| Other Senior Non Contract | $45 | 111% |
| Prospect Health Plan | $45 - $68 | 111% |
| Scan Health Plan | $45 | 111% |
| Self Pay Ab774/Cbo Use Only | $45 | 111% |
| UnitedHealthcare | $45 - $220 | 111% |
| Us Dept Of Labor | $45 | 111% |
| Us Federal Marshall/Department Of Immigration | $45 | 111% |
| Velocity Provider Network Sr | $45 | 111% |
| Verda Health Plan Sr | $45 | 111% |
| Veterans Administration | $45 | 111% |
| Victim Of Violent Crime | $45 | 111% |
| Victoria Hospice | $45 | 111% |
| First Health | $46 | 114% |
| Aetna | $48 | 119% |
| Brand New Day | $51 | 126% |
| Prime Health Srvs | $52 - $70 | 129% |
| Heritage Provider Network | $53 | 131% |
| Magellan | $53 | 131% |
| Cigna | $57 - $315 | 141% |
| County Of Orange/Custody/Advanced Medmgt | $57 | 141% |
| Veterans Evaluation Services | $57 | 141% |
| Multiplan | $62 | 153% |
| Networks By Design | $62 | 153% |
| Networks By Design Wc | $62 | 153% |
| Staywell/Island Home Ins | $63 | 156% |
| Healthsmart | $66 | 163% |
| Interplan | $66 | 163% |
| Prime Health | $66 | 163% |
| Pnoa-Provider Network Of America | $70 | 173% |
| Prime Health Srvs/Network | $75 | 186% |
| Three Rivers Network | $79 | 195% |
| Velocity National Provider Network Ppo | $79 | 195% |
| Lucet Behavioral Health Sr | $88 | 218% |
| Managed Health Network | $88 | 218% |
| Other Insurance Loa | $88 | 218% |
| Other Non Contracted Plans | $88 | 218% |
| Private Pay | $88 | 218% |
| Us Behavioral Health Plan | $88 | 218% |
| Vitas Hospice | $88 | 218% |
| Monarch Health Plan | $179 | 443% |