CMS Price Transparency Data

Prosthetic fitting and training

Facility: Cass County Memorial Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $48
Cash Discount Price: $78
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Cass County Memorial Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.19x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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: $78 (193%)

Insurance Median: $48 (119%)

Cash: $78 (193% of Medicare)

Ins. Median: $48 (119% 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
Midlands Choice Medica Mcr	$22	54%
Triwest - All Plans	$45	111%
Aetna	$47 - $105	116%
Amerigroup Mcr Adv - All Other Plans	$47	116%
Medica Mcr Adv	$47	116%
Tricare	$47	116%
UnitedHealthcare	$47 - $101	116%
Va Ccn - All Plans	$47	116%
Wellmark Mcr Adv	$47	116%
American Hlth Mcr Adv - All Plans	$48	119%
Iowa Total Care Mcaid	$48	119%
Iowa Total Care Mcr	$48	119%
Medicaid / KanCare	$48	119%
Molina Mcaid - All Plans	$48	119%
Iowa Total Care Comm - All Other Plans	$51	126%
Midlands Choice New Bus	$72	178%
Medica Comm - All Other Plans	$98	243%
Midlands Choice Pho (Ppo) - All Other Plans	$100	247%
Multiplan - All Plans	$105	260%
Wellmark Hmo	$158	391%
Wellmark Ppo - All Other Plans	$174	431%

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 $78.
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 Cass County Memorial 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.