CMS Price Transparency Data

Prosthetic fitting and training

Facility: North Shore Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $54
  • Cash Discount Price: $319
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at North Shore Medical Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.34x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$319

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $319 (789%)
Insurance Median: $54 (134%)
Cash: $319 (789% of Medicare)
Ins. Median: $54 (134% 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
Aetna $10 - $230 25%
Veterans Administration Mill Bill $29 72%
Medicare (plans) $37 - $319 92%
Humana $39 - $75 97%
Dimension Health Wc $40 99%
Workers Compensation $40 99%
Devoted Health $41 101%
Leon Health Inc $41 101%
Tricare $41 101%
UnitedHealthcare $41 - $364 101%
Bc/Bs Myblue Hmo Hix $42 104%
Employer Direct Healthcare $42 - $52 104%
Hospice Other $42 104%
Veterans Administration Vaccn $42 104%
Cigna $43 - $160 106%
Healthsun Health Plans $43 106%
Longevity Health Plan $44 109%
Bc/Bs Of Fl Health Options Hmo $46 114%
Bc/Bs Of Fl Ppo $46 114%
Bc/Bs Of Fl Simplyblue $46 114%
Bc/Bs Of Fl Network Blue $49 121%
Florida Pace Centers $49 121%
Bright Health Management Commercial $50 124%
Centurion Prison $51 126%
Self Pay/Uninsured $51 126%
Bc/Bs Of Fl Blue Select Exchange Non Par $52 129%
Avmed Exchange $73 181%
Ambetter / Centene $77 191%
Molina Marketplace Program Exchange $79 195%
Medicaid / KanCare $80 - $319 198%
Auto Insurance $83 205%
Avmed Select Network $85 210%
Amerihealth Caritas Next Exchange $89 220%
Oscar Health Plan Hix $114 282%
Imagine Health $161 398%
Bc/Bs Of Fl Phs $166 411%
Avmed Broad Network $171 423%
Magellan Behavioral Health $192 475%
Dimensions International $208 515%
First Health $217 537%
Dimension Health Ppo $240 594%
Beacon Health Strategies Commercial $319 789%
Commercial Non-Contracted $319 789%
Self Pay - Mcd Pending 100 Percent $319 789%
Single Case Agreement $319 789%
United Behavioral Health Psych $319 789%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals