CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $75
  • Cash Discount Price: $255
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Healthone Presbyterian St Luke's is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.86x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.
Cash / Self-Pay
$255

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $255 (631%)
Insurance Median: $75 (186%)
Cash: $255 (631% of Medicare)
Ins. Median: $75 (186% 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.

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
UnitedHealthcare $36 89%
Vail Health $38 - $39 94%
Aetna $42 - $137 104%
Blue Cross Blue Shield $42 - $192 104%
Bright Health $42 - $78 104%
Cigna $42 - $166 104%
Devoted Health $42 104%
Humana $42 104%
Kaiser National Transplant $42 - $125 104%
Mutual Of Omaha $42 104%
Rocky Mountain Health $42 104%
Total Longterm Care $42 104%
Triwest Health Alliance $42 104%
United $42 - $117 104%
Innovage Pace $43 106%
Kaiser $43 - $67 106%
Wellcare $43 106%
Delaware Life Insurance $44 109%
Emerging Therapy Solutions $120 - $166 297%
Colorado Program For Children With Special Needs $127 - $132 314%
Western Plains Community Health $162 - $169 401%
Multiplan $175 - $234 433%
Northcare $175 - $182 433%
Physician Health Partners $175 - $182 433%
Pinnacol Workers Comp $187 - $195 463%
Medical Development International $200 - $208 495%
Prime Health $225 - $234 557%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1719 E 19Th Ave, Denver, CO 80218
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals