CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Florida Orange Park Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $61
Cash Discount Price: $504
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Florida Orange Park Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $504. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.51x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$504

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $504 (1247%)

Insurance Median: $61 (151%)

Cash: $504 (1247% of Medicare)

Ins. Median: $61 (151% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Hospice Community	$32	79%
Hospice Haven	$36	89%
Humana	$39 - $207	97%
Blue Cross Blue Shield	$40	99%
Careplus	$40	99%
Devoted Health	$40	99%
Ndms Definitive Care	$40	99%
United	$40 - $227	99%
United Behavioral Health	$40	99%
Veterans Evaluation Services	$40	99%
Wellmed	$40	99%
American Health Plan	$42	104%
Cigna	$42 - $143	104%
Florida Complete Care	$42	104%
Optimum Healthcare	$42	104%
Sunshine State	$42	104%
Wellcare	$42	104%
Gold Kidney	$43	106%
Corvel Corporation	$44	109%
Prime Health	$45	111%
Longevity	$47	116%
Clay County Sheriffs Office	$49	121%
Avmed	$61 - $141	151%
Simply Healthcare	$64 - $78	158%
Oscar	$81	200%
Aetna	$87 - $151	215%
Positive Healthcare	$111	275%
Sunshine State Health Plan	$129	319%
Molina Healthcare	$136	337%
Medicare (plans)	$227	562%
Plotkin Health	$252	624%
Multiplan	$393 - $429	973%
Evernorth	$403	997%
Evolutions Healthcare	$403 - $429	997%
Ppo Next	$429	1062%
Novanet	$454	1123%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $504.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97761.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Orange Park Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97761.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.