Prosthetic fitting and training
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $70
- Cash Discount Price: $51
- vs. Medicare Baseline: 1.73x 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 |
|---|---|---|
| Aetna | $70 | 173% |
| Blue Cross Blue Shield | $70 | 173% |
| Black Lung [6055] | $70 | 173% |
| Oncology Patient Assistance Programs [2295] | $70 | 173% |
| Lucent Health [6000] | $70 | 173% |
| Web Tpa [2115] | $70 | 173% |
| Healthcare Highways [2210] | $70 | 173% |
| Hooray Health [8000] | $70 | 173% |
| Department Of Corrections [1340] | $86 | 213% |
| Healthpartners [1500] | $99 | 245% |
| National Association Of Letter Carriers [1695] | $99 | 245% |
| American Postal Workers Union [1070] | $99 | 245% |
| Cigna | $99 | 245% |
| Humana | $101 | 250% |
| 1199 Seiu Benefit Fund [3505] | $115 | 285% |
| American Healthcare [1055] | $133 | 329% |
| Administrative Concepts [1005] | $133 | 329% |
| First Health [1375] | $133 | 329% |
| Multiplan [1680] | $133 | 329% |
| Coventry Healthcare [1320] | $140 | 346% |
| Ks Disability Determination [6090] | $171 | 423% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," the University Of Kansas Health System - St Francis Campus in Topeka, KS, lists a gross charge of $171.00. This amount aligns exactly with the median negotiated rate of $70.00 across 21 payers, though specific payer contracts vary significantly, with rates ranging from $70.00 for plans like Aetna and Blue Cross Blue Shield up to $171.00 for Ks Disability Determination. When comparing this facility's pricing to the broader market, the cash median of $51.00 is notably lower than the negotiated amounts most insurers pay. For patients with high-deductible plans, paying the cash price of $51.00 upfront may be more cost-effective than relying on insurance, which often results in higher out-of-pocket costs if the deductible has not yet been met or if the negotiated rate exceeds the cash price.
It is important to understand that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific coverage status before scheduling. If you are self-pay, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims. Additionally, if you receive a bill, always request a detailed, itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes