CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Florida Raulerson Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $94
  • Cash Discount Price: $720
  • vs. Medicare Baseline: 2.33x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Florida Raulerson Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $720. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.33x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
$720

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $720 (1782%)
Insurance Median: $94 (233%)
Cash: $720 (1782% of Medicare)
Ins. Median: $94 (233% 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 233% of the Medicare baseline (a markup of 133%). 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 $39 - $288 97%
Blue Cross Blue Shield $40 99%
Careplus $40 99%
Devoted Health $40 99%
Ndms Definitive Care $40 99%
Ultimate Health Plan $40 99%
United $40 - $324 99%
Veterans Evaluation Services $40 99%
Wellmed $40 99%
Aetna $41 - $216 101%
American Health Plan $42 104%
Cigna $42 - $253 104%
Florida Complete Care $42 104%
Prominence Healthfirst $42 104%
Sunshine State $42 - $44 104%
Centurion $44 109%
Corvel Corporation $44 109%
Careworks (Rockport) $45 111%
Prime Health $45 111%
Amerihealth Caritas $47 116%
Longevity Health Plan $47 116%
Solis Health Plan $57 141%
Freedom Health $62 - $115 153%
Optimum $62 153%
Avmed $94 - $360 233%
Simply Healthcare Plans $94 233%
Molina $137 - $194 339%
Oscar $137 339%
Health Sun Health Plan $153 379%
Simply Healthcare $169 418%
Sunshine State Health Plan $184 455%
United Ppo $317 784%
Plotkin Health $360 891%
Prime Health Sherriff $360 891%
Multiplan $540 - $612 1336%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals