Prosthetic fitting and training
Facility: Pratt Regional Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $67
- Cash Discount Price: $56
- vs. Medicare Baseline: 1.66x 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 |
|---|---|---|
| Celtic Insurance Company | $39 | 97% |
| Healthy Blue | $40 | 99% |
| UnitedHealthcare | $43 - $82 | 106% |
| Christian Health Aid | $60 | 148% |
| Health Partners Of Kansas | $68 | 168% |
| Aetna | $72 | 178% |
| Choicecare | $80 | 198% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Pratt Regional Medical Center in Pratt, KS, lists a cash median price of $56.00, which is lower than the facility's gross charge of $80.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $43 to $82, the cash price may offer significant savings for patients with high-deductible plans or those without insurance, as the cash rate is notably lower than the insurance negotiated amounts. It is important to note that commercial rates often include administrative overhead and do not reflect the true cost of care; comparing these figures to the Medicare benchmark of $40.41 reveals that the cash price is already competitive, approaching the federal baseline without the markup typically found in commercial contracts.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it does not eliminate the need to verify your specific plan's allowed amount before scheduling. If your insurance allows a rate higher than the cash price, paying out-of-pocket upfront could result in a lower total cost, provided you have a valid reason to forgo insurance coverage or can secure a prompt-pay discount. Before finalizing any payment, we strongly recommend requesting a formal itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a written audit dispute. Additionally, always ask the billing department about self-pay or prompt-pay discounts prior to check-in to avoid being locked into insurance processing that may void potential cash savings.