CMS Price Transparency Data

Prosthetic fitting and training

Facility: Marion Communtiy Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $52
  • Cash Discount Price: $289
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Marion Communtiy Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $289. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.29x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$289

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $289 (715%)
Insurance Median: $52 (129%)
Cash: $289 (715% of Medicare)
Ins. Median: $52 (129% 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
Avmed $34 - $82 84%
Simply Healthcare $36 - $37 89%
Humana $38 - $58 94%
Blue Cross Blue Shield $40 99%
Devoted Health $40 99%
Freedom Optimum $40 99%
Ndms Definitive Care $40 99%
United $40 - $131 99%
Va Purchased Care Program $40 99%
Veterans Evaluation Services $40 99%
Wellmed $40 99%
Aetna $42 - $87 104%
Align Senior Care $42 104%
American Health Plan $42 104%
Cigna $42 - $121 104%
Florida Complete Care $42 104%
Sunshine State $42 104%
Wellcare $42 104%
Gold Kidney Of Florida $43 106%
Secur $43 106%
Centurion $44 109%
Clear Spring Health $44 109%
Corvel Corporation $44 109%
Careplus $45 111%
Prime Health $45 111%
Ultimate Health Plan $45 111%
Careworks (Rockport Community) $46 114%
Marion County Schools $46 114%
Longevity Health Plan $47 116%
Molina Healthcare $54 - $93 134%
Evolutions $66 - $67 163%
Evolutions Healthcare $66 - $67 163%
Sunshine State Health Plan $73 - $74 181%
Naphcare $83 - $95 205%
University Ma Federal Corrections $83 205%
Wellpath $83 - $95 205%
Plotkin Health $143 - $146 354%
Prime Health Sheriff $143 - $146 354%
Multiplan $223 - $227 552%
Ppo Next $243 - $247 601%
Novanet $257 - $262 636%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals