CMS Price Transparency Data

Prosthetic fitting and training

Facility: Kapiolani Medical Center for Women & Children

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $75
Cash Discount Price: $89
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Kapiolani Medical Center for Women & Children is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.86x the Medicare baseline. Located in 1319 Punahou Street, Honolulu, HI.

Cash / Self-Pay

$89

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: $89 (220%)

Insurance Median: $75 (186%)

Cash: $89 (220% 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.

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
Ohana	$19 - $63	47%
UnitedHealthcare	$27 - $46	67%
Alohacare	$43 - $60	106%
Uha	$49 - $3,145	121%
Hmsa	$52	129%
Kaiser	$52 - $134	129%
Mdx	$52 - $122	129%
Devoted	$55	136%
Mimoh	$102 - $114	252%
Hwmg/Hmaa	$116 - $121	287%
Hcha	$117 - $122	290%
Multiplan	$117 - $129	290%
Verdegard	$117 - $122	290%
Mccp	$124 - $129	307%
Coventry	$131 - $137	324%

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 $89.
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 Kapiolani Medical Center for Women & Children 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.