CMS Price Transparency Data

Prosthetic fitting and training

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 97761 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$113

about 2.8× the $40 Medicare rate · typically $40–$196

modeled estimate · not a bill or quote

Medicare pays $40 Fair price $113 Cash price $86 Hospital's list price $143

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$96 - $175	238%
Blue Cross Blue Shieldmajor	$158	391%
Aetnamajor	$86 - $156	213%
Cignamajor	$98 - $178	243%
HealthPartners	$76 - $147	188%
+ 2 smaller / regional plans	$53 - $120

Government programs also on file: Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 86), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 97761.

Insurance Before you use insurance

Call your insurance company to confirm Iowa Specialty Hospital - Clarion is in-network.
Ask your insurer whether prior approval is required for CPT code 97761.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Iowa Specialty Hospital - Clarion

Compare: Prosthetic fitting and training at other IA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.