CMS Price Transparency Data

Prosthetic fitting and training

Facility: Adventist Health Tehachapi Valley

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $79
Cash Discount Price: $44
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Adventist Health Tehachapi Valley is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.95x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $44 (109%)

Insurance Median: $79 (195%)

Cash: $44 (109% of Medicare)

Ins. Median: $79 (195% 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
Healthnet Mcare	$31	77%
Medicare (plans)	$31	77%
Tricare	$31	77%
UnitedHealthcare	$31 - $79	77%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$31	77%
Network Providers- All Plans	$39	97%
Klhp-Kern Legacy Epo -All Other Plans	$44 - $55	109%
Kaiser Ip/Op Only- All Other Plans	$53	131%
Western Grwrs/Pinnacle - All Plans	$68	168%
Centivo - All Plans	$69	171%
Oscar Health Plan- All Plans	$69	171%
Aetna	$77	191%
Ah Employee Health Plan - All Plans	$86	213%
Blue Cross Blue Shield	$93 - $98	230%
Blue Shield Epn- All Other Plans	$98	243%
Healthnet- All Other Plans	$125	309%
Cigna	$127	314%
Coventry- All Plans	$146	361%
Kaiser Medi-Cal Ip/Op Only	$162	401%
Medi-Cal	$162	401%
Universal Ipa Mcal Op/Profee Only	$162	401%
Bc Mcal	$167	413%
Blue Shield Non-Epn	$171	423%
Healthnet Medi-Cal	$199	492%
Khs-Kern Hlth Systm Mcal	$209	517%

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 $44.
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 Tehachapi Valley 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.