CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Florida Kendall Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $82
  • Cash Discount Price: $609
  • vs. Medicare Baseline: 2.03x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Florida Kendall Hospital is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $609. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.03x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.
Cash / Self-Pay
$609

Average discount available for prompt cash payment at this facility.

Insurance Median
$82

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: $609 (1507%)
Insurance Median: $82 (203%)
Cash: $609 (1507% of Medicare)
Ins. Median: $82 (203% 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 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Humana $40 - $207 99%
Careplus Sfl $42 104%
Cigna $42 - $128 104%
Devoted Health $42 104%
Leon Health $42 104%
Ndms Definitive Care $42 104%
United $42 - $274 104%
United Behavioral Health $42 104%
Veterans Evaluation Services $42 104%
Wellmed $42 104%
Aetna $43 - $183 106%
Blue Cross Blue Shield $43 106%
American Health Plan $44 109%
Oscar $44 - $97 109%
Prominence Healthfirst $44 109%
Sunshine State $44 - $46 109%
Align $45 111%
Avmed $45 - $304 111%
Florida Complete Care $45 111%
Centurion $46 114%
Doctors Healthcare Plan $46 114%
Corvel Corporation $47 116%
Gold Kidney $47 116%
Careworks (Rockport) $48 119%
Prime Health $48 119%
Amerihealth Caritas $50 - $104 124%
Longevity Health Plan $50 124%
Freedom Health $52 - $97 129%
Optimum $52 129%
Solis Health Plan $61 151%
Naphcare $71 176%
Simply Healthcare Plans $79 195%
Simply Healthcare $82 203%
Seven Corners $88 - $101 218%
Wellpath $88 - $101 218%
Molina $116 - $164 287%
Health Sun Health Plan $130 322%
Aids Healthcare $134 - $731 332%
Mmm Of Fl (Health Advantage Plan) $140 346%
United Ppo $144 356%
Sunshine State Health Plan $158 391%
Plotkin Health $304 752%
Prime Health Sherriff $304 752%
Medica Healthcare $353 874%
Multiplan $457 - $518 1131%
Evernorth Bh $487 1205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11750 Bird Rd, Miami, FL 33175
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals