CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Florida Palms West Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $137
  • Cash Discount Price: $666
  • vs. Medicare Baseline: 3.39x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Florida Palms West Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $666. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 3.39x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.
Cash / Self-Pay
$666

Average discount available for prompt cash payment at this facility.

Insurance Median
$137

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: $666 (1648%)
Insurance Median: $137 (339%)
Cash: $666 (1648% of Medicare)
Ins. Median: $137 (339% 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 339% of the Medicare baseline (a markup of 239%). 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 - $231 97%
Careplus Sfl $41 101%
Devoted Health $41 101%
Ndms Definitive Care $41 101%
United $41 - $306 101%
Veterans Evaluation Services $41 101%
Wellmed $41 101%
Aetna $42 - $204 104%
Blue Cross Blue Shield $42 104%
American Health Plan $43 106%
Oscar $43 - $109 106%
Prominence Healthfirst $43 106%
Sunshine State $43 - $45 106%
Align $44 109%
Cigna $44 - $143 109%
Florida Complete Care $44 109%
Centurion $45 111%
Doctors Healthcare Plan $45 111%
Corvel Corporation $46 114%
Gold Kidney $46 114%
Careworks (Rockport) $47 116%
Prime Health $47 116%
Amerihealth Caritas $49 - $116 121%
Longevity Health Plan $49 121%
Freedom Health $56 - $109 139%
Optimum $56 - $58 139%
Solis Health Plan $59 146%
Avmed $85 - $340 210%
Simply Healthcare Plans $85 - $88 210%
Simply Healthcare $88 - $92 218%
Molina $124 - $184 307%
Health Sun Health Plan $139 - $145 344%
Aids Healthcare $143 - $816 354%
Mmm Of Fl (Health Advantage Plan) $150 - $156 371%
United Ppo $155 - $161 384%
Sunshine State Health Plan $170 - $177 421%
Health Care District $326 - $340 807%
Palm Beach Juvenile Correction $326 - $340 807%
Plotkin Health $326 - $340 807%
Prime Health Sherriff $326 - $340 807%
Medica Healthcare $378 - $394 935%
Multiplan $489 - $578 1210%
Healthy Palm Beaches $550 1361%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13001 Southern Blvd, Loxahatchee, FL 33470
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals