CMS Price Transparency Data

Prosthetic fitting and training

Facility: Deaconess Illinois Crossroads

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $99
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Deaconess Illinois Crossroads is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.45x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$99

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: $49 (121%)
Insurance Median: $99 (245%)
Cash: $49 (121% of Medicare)
Ins. Median: $99 (245% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 245% of the Medicare baseline (a markup of 145%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
UnitedHealthcare $17 - $130 42%
Self-Pay $30 - $49 74%
Cigna $33 - $87 82%
Aetna $38 - $177 94%
Alliance Coal $38 - $63 94%
Blue Cross Blue Shield $38 - $106 94%
Humana $38 - $175 94%
Meridian Health Plan $38 94%
Mytru Advantage $38 94%
Umwa $38 94%
Wellcare $38 94%
Care Improvement Plus $39 97%
Molina Healthcare Of Illinois $39 97%
Alter-Net Medical Services, Inc. $47 - $110 116%
Noncontracted $62 153%
Prime Health Services $64 - $168 158%
Guardian Resources, Inc. $72 - $188 178%
Healthcare'S Finest Network (Hfn) $73 - $190 181%
Medicalcontrol Network Solutions $73 - $190 181%
National Provider Network $73 - $190 181%
Three Rivers Provider Network $75 - $195 186%
Beech Street $76 - $197 188%
Hope Trust $78 - $110 193%
Wexford Health Sources $101 - $157 250%
Deaconess Onecare $119 - $123 294%
Encore Prime/Elite/Elite + $123 - $127 304%
Encore Combined $137 - $141 339%
Great West Healthcare Of Illinois $168 416%
Multiplan - Primary Network - Phcs $176 436%
Healthlink $179 - $190 443%
Coventry Healthcare $188 465%
First Health $188 465%
Multiplan - Complementary Network $191 473%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8 Doctors Park Rd, Mount Vernon, IL 62864
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals