CMS Price Transparency Data

Prosthetic fitting and training

Facility: Kosciusko Community Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $63
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Kosciusko Community Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.56x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $32 (79%)
Insurance Median: $63 (156%)
Cash: $32 (79% of Medicare)
Ins. Median: $63 (156% 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.

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
Amish Aid $16 - $43 40%
Self Pay $16 - $81 40%
Theramatrix $23 57%
Lutheran Preferred Network $25 - $166 62%
Physicians Health Plan $29 - $95 72%
Php Freedom Network $30 - $80 74%
UnitedHealthcare $30 - $186 74%
Encore $31 - $83 77%
Trma Inc $31 - $93 77%
Aetna $32 - $110 79%
Tricare $36 89%
Blue Cross Blue Shield $38 - $186 94%
Department Of Veterans Affairs $38 94%
Humana $38 - $186 94%
Medicare (plans) $38 94%
Mhs $38 - $186 94%
Veterans Eval Services $38 94%
Iu Health $39 97%
Node Devoted Health Mcr Adv $39 97%
Node Non Par Hospice Agree $39 97%
Node Va $39 97%
One Call Care Diagnostics Wc $39 97%
In Dept Of Correction $40 99%
Node Pphp Mcr Adv $40 99%
Connecticut General Life Insurance Company $46 - $122 114%
Cigna $49 - $131 121%
First Health Network $58 - $155 144%
Lutheran Advanced Network $58 144%
Lutheran Preferred $58 - $77 144%
Prime Health Services $58 - $155 144%
Us Department Of Labor $61 151%
Align In Work Comp $62 153%
One Call Work Comp $62 153%
Advantage Health $65 - $172 161%
Private Healthcare Systems $67 - $178 166%
Encore Work Comp In $69 171%
Sagamore $69 - $195 171%
Encore Health Network $73 - $193 181%
Managed Health Services Exchange $77 191%
Workers Comp $77 191%
Encore Kba Epo $92 228%
Encore Kba Ppo $116 287%
Caresource $143 - $186 354%
Managed Health Services $186 460%
Medicaid / KanCare $186 460%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals