CMS Price Transparency Data

Prosthetic fitting and training

Facility: Memorial Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $68
Cash Discount Price: $113
vs. Medicare Baseline: 1.68x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Memorial Medical Center is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.68x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$113

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: $113 (280%)

Insurance Median: $68 (168%)

Cash: $113 (280% 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.

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
Blue Cross Blue Shield	$25 - $113	62%
Veterans Administration	$27	67%
Health Alliance	$36 - $73	89%
Aetna	$38 - $86	94%
Medicare (plans)	$38 - $113	94%
Tricare	$38	94%
UnitedHealthcare	$38 - $70	94%
Humana	$40 - $68	99%
Medicaid / KanCare	$45	111%
Molina	$46	114%
Current Health Network Ppo	$51	126%
Healthlink	$56 - $71	139%
Commercial Workers Compensation	$57	141%
Cigna	$59	146%
Illinois Workers Compensation	$60	148%
Phcs/Multiplan	$61 - $68	151%
6 Degrees Health	$68	168%
Hopetrust	$68	168%
Hst	$68	168%
Magellan	$68	168%
Consociate	$73	181%
Hfn	$73	181%
Preferred Plan	$85	210%
Soi Mcfarland	$85	210%
Soi Rushville	$85	210%
Corvel	$90	223%
Methodist First Choice	$90	223%
Mutual Medical Plans	$96	238%
Liability	$113	280%

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 $113.
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 Memorial 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.