Prosthetic fitting and training
Facility: The Orthopaedic Hospital of Lutheran Health Networ
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $66
- Cash Discount Price: $58
- vs. Medicare Baseline: 1.63x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Physicians Health Plan | $19 - $142 | 47% |
| Amish Aid | $21 - $99 | 52% |
| Self Pay | $21 - $99 | 52% |
| Lutheran Preferred | $23 - $220 | 57% |
| Theramatrix | $23 | 57% |
| Php Freedom Network | $24 - $77 | 59% |
| Cigna | $27 - $367 | 67% |
| Aetna | $30 - $178 | 74% |
| Three Rivers Preferred | $31 - $165 | 77% |
| UnitedHealthcare | $34 - $186 | 84% |
| Tricare | $36 | 89% |
| Blue Cross Blue Shield | $38 - $186 | 94% |
| Department Of Veterans Affairs | $38 | 94% |
| Humana | $38 - $186 | 94% |
| Iu Health Plan | $38 | 94% |
| Medicare (plans) | $38 | 94% |
| Node Mhs Mcr Adv | $38 | 94% |
| Sagamore | $38 - $177 | 94% |
| Small Business Aid | $38 | 94% |
| Encore Ppo | $39 - $184 | 97% |
| Node Devoted Health Mcr Adv | $39 | 97% |
| Node Hospice Non Par Agree | $39 | 97% |
| Node Va | $39 | 97% |
| Police And Sheriff | $39 | 97% |
| In Dept Of Correction | $40 | 99% |
| Node Pphp Mcr Adv | $40 | 99% |
| One Call Work Comp | $40 | 99% |
| Multiplan | $54 - $286 | 134% |
| Lutheran Advanced Network | $58 | 144% |
| Node Lutheran Three Rivers Preferred Plus 150 | $58 | 144% |
| Occunet In Work Comp | $58 - $80 | 144% |
| Prime Health Services | $58 - $275 | 144% |
| First Health | $60 - $283 | 148% |
| Node Us Dept Of Labor | $61 | 151% |
| Align Network | $62 | 153% |
| Encore | $62 - $294 | 153% |
| Node Lutheran Three Rivers Preferred Plus 175 | $67 | 166% |
| Encore Wc | $69 | 171% |
| Medrisk In Work Comp | $69 | 171% |
| Three Rivers Preferred In Work Comp | $69 | 171% |
| Objective Surgical | $75 | 186% |
| In Work Comp | $77 | 191% |
| Lutheran Network | $77 | 191% |
| Managed Health Services | $77 - $186 | 191% |
| Encore Kba Epo | $92 | 228% |
| Objective Surgery Work Comp | $110 | 272% |
| Encore Kba Ppo | $116 | 287% |
| Medicaid / KanCare | $143 - $186 | 354% |
| Caresource | $186 | 460% |
| Mhs | $186 | 460% |