CMS Price Transparency Data

Prosthetic fitting and training

Facility: Lutheran Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $150
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.71x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Lutheran Medical Center is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 3.71x the Medicare baseline. Located in 8300 W 38Th Ave, Wheat Ridge, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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%)

Insurance Median: $150 (371%)

Ins. Median: $150 (371% 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 371% of the Medicare baseline (a markup of 271%). 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
Aarp	$41	101%
UnitedHealthcare	$41 - $200	101%
Kaiser Snp	$42	104%
Select Health	$42	104%
Kaiser Perm Hmo	$64 - $145	158%
Kaiser Self Funded	$79 - $145	195%
Kaiser Perm Ppo/Pos	$80 - $150	198%
Allegiance	$86	213%
Cigna	$86 - $344	213%
Denv Hlth Med Plan	$109	270%
Aetna	$128 - $309	317%
Blue Cross Blue Shield	$137 - $289	339%
Geha	$137 - $200	339%
Preferred One	$137	339%
Humana	$145	359%
Cofinity	$248	614%
First Health Network	$248	614%
Private Hlthcare Sys	$258	638%
Multiplan Inc	$289	715%

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 $X.
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 Lutheran Medical Center 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.