CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Florida Highlands Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $44
  • Cash Discount Price: $204
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Florida Highlands Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.09x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$204

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $204 (505%)
Insurance Median: $44 (109%)
Cash: $204 (505% of Medicare)
Ins. Median: $44 (109% 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
Freedom Health $18 45%
Avmed $27 - $102 67%
Aetna $36 - $61 89%
Molina $39 97%
Oscar $39 97%
Blue Cross Blue Shield $40 99%
Devoted Health $40 99%
Humana $40 - $82 99%
Ndms Definitive Care $40 99%
United $40 - $92 99%
Wellmed $40 99%
American Health Plan $42 104%
Cigna $42 - $72 104%
Florida Complete Care $42 104%
Prominence Healthfirst $42 104%
Sunshine State $42 - $44 104%
Centurion $44 109%
Prime Health $45 111%
Amerihealth Caritas $47 116%
Longevity Health Plan $47 116%
Simply Healthcare $48 119%
Office Of Sheiff Highland Co $71 176%
United Ppo $90 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals