CMS Price Transparency Data

Prosthetic fitting and training

Facility: Doctors Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $75
  • Cash Discount Price: $331
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Doctors Hospital is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $331. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.86x the Medicare baseline. Located in 3651 Wheeler Road, Augusta, GA.
Cash / Self-Pay
$331

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $331 (819%)
Insurance Median: $75 (186%)
Cash: $331 (819% of Medicare)
Ins. Median: $75 (186% 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
Blue Choice $15 37%
Health Net $37 92%
Humana $37 - $38 92%
Aetna $38 - $188 94%
Devoted Health $38 94%
Healthspring $38 94%
Regency Hospice $38 94%
St Joseph Hospice $38 94%
United $38 - $153 94%
Absolute Total Care $39 - $61 97%
Blue Cross Blue Shield $39 97%
Coventry $39 97%
Wellcare $39 - $68 97%
Clover $40 99%
Eon Health $40 99%
Georgia Assurance $40 99%
Shared Health $40 99%
Cigna $42 - $78 104%
Qtc Medical Group $46 114%
Amerigroup $47 - $48 116%
Ambetter / Centene $48 - $50 119%
Friday Health $56 - $58 139%
Nhc Advantage $63 - $65 156%
Pruitt Health $63 - $65 156%
Peach State $66 - $68 163%
Centurion $91 - $94 225%
Americas 1St Choice $92 - $95 228%
Health One Alliance $152 - $157 376%
Medcost $165 - $217 408%
Kaiser Permanente $180 - $186 445%
Multiplan $198 - $306 490%
Performax $224 - $231 554%
First Health $247 - $255 611%
Employer'S Health Network $264 - $272 653%
Novanet $296 - $306 732%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3651 Wheeler Road, Augusta, GA 30909
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals