CMS Price Transparency Data

Prosthetic fitting and training

Facility: Mercyone Dubuque Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $68
  • Cash Discount Price: $641
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Mercyone Dubuque Medical Center is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $641. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.68x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$641

Average discount available for prompt cash payment at this facility.

Insurance Median
$68

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: $641 (1586%)
Insurance Median: $68 (168%)
Cash: $641 (1586% of Medicare)
Ins. Median: $68 (168% 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
Iowa Total Care $25 - $50 62%
Medicaid / KanCare $25 - $50 62%
Preferred Health Choice $30 74%
Health Choices $31 77%
Aetna $38 - $71 94%
Blue Cross Blue Shield $38 94%
Medicare (plans) $38 - $39 94%
UnitedHealthcare $38 - $231 94%
Midlands Choice $49 - $76 121%
Amish Hospital Aid $51 126%
The Alliance $51 126%
Wps $51 126%
Oscar $52 129%
Centivo $60 148%
Ambetter / Centene $65 161%
Mhnet $68 168%
1199 National Benefit Fund $71 176%
Allied Benefit Systems $71 176%
Asr Health Benefits $71 176%
Christian Brother Services $71 176%
Coventry $71 176%
First Health $71 176%
Lucent Health $71 176%
Luminare Health $71 176%
Medical Mutual $71 176%
Meritain $71 176%
Trustmark Small Business Benefits $71 176%
Webtpa $71 176%
Auxiant $76 188%
Cigna $76 188%
Medica $76 188%
Midlands $76 188%
Multiplan $76 188%
Unity $76 188%
Claimdoc $77 191%
Nova $77 191%
Crime Victim Assistance $85 210%
Iowa Dept Of Public Health $85 210%
Stephenson Cty Health $85 210%
Geha $231 572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals