CMS Price Transparency Data

Prosthetic fitting and training

Facility: HCA Florida Poinciana Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $61
Cash Discount Price: $850
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at HCA Florida Poinciana Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $850. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.51x the Medicare baseline. Located in 325 Cypress Pkwy, Kissimmee, FL.

Cash / Self-Pay

$850

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: $850 (2103%)

Insurance Median: $61 (151%)

Cash: $850 (2103% 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
Humana	$38 - $238	94%
Blue Cross Blue Shield	$40	99%
Devoted Health	$40	99%
Fl Health Care Plan	$40	99%
Ndms Definitive Care	$40	99%
United	$40 - $382	99%
Wellmed	$40	99%
Aetna	$41 - $255	101%
Align Senior Care	$42	104%
American Health Plan	$42	104%
Avmed	$42 - $425	104%
Cigna	$42 - $148	104%
Florida Complete Care	$42	104%
Sunshine State	$42	104%
Wellcare	$42	104%
Gold Kidney Of Florida	$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%
Longevity Health Plan	$47	116%
Solis Health Plan	$57	141%
Freedom Health	$61	151%
Optimum	$61	151%
Oscar	$136	337%
Simply Healthcare	$142	351%
Molina Healthcare	$161 - $229	398%
Evolutions	$195	483%
Sunshine State Health Plan	$217	537%
Plotkin Health	$425	1052%
Prime Health Sheriff	$425	1052%
Multiplan	$637 - $722	1576%

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 $850.
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 Poinciana 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.