CMS Price Transparency Data

Prosthetic fitting and training

Facility: Eastern Idaho Regional Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $57
Cash Discount Price: $106
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Eastern Idaho Regional Medical Center is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.41x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $106 (262%)

Insurance Median: $57 (141%)

Cash: $106 (262% of Medicare)

Ins. Median: $57 (141% 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
Select Health	$32	79%
Select Health Ichn Brightpath	$32 - $36	79%
Blue Cross Blue Shield	$33 - $101	82%
Molina	$33 - $38	82%
Select Health Idaho (Eirmc Only)	$34	84%
Prime Health	$38 - $90	94%
Regence Blue Shield	$38	94%
Rexburg Care And Rehab	$38	94%
Triwest Healthcare Alliance	$38	94%
Veteran'S Administration	$38	94%
Humana	$39 - $89	97%
United	$39 - $61	97%
Aetna	$42 - $52	104%
Doug Andrus Distributing	$42	104%
Pacificsource Health	$44 - $57	109%
University Of Utah	$44	109%
Mountain Health Co-Op	$53 - $79	131%
Cigna	$58	144%
Regence	$62	153%
First Choice Health Of Washington	$64	158%
Moda	$66	163%
Dmba	$68	168%
Geha Ppo Usa	$85	210%
Multiplan	$89 - $95	220%
First Choice Of The Midwest	$95	235%
Interwest Health	$95	235%
St. John'S Health Network	$95	235%
Coventry First Health	$96	238%
Shashone-Bannock Tribal Health	$106	262%

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 $106.
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 Eastern Idaho Regional Medical Center 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.