Prosthetic fitting and training
Facility: University Of Kansas Hospital
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $103
- Cash Discount Price: $32
- vs. Medicare Baseline: 2.55x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 255% of the Medicare baseline (a markup of 155%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ku Athletics [503200094] | $38 | 94% |
| UnitedHealthcare | $38 - $256 | 94% |
| Workers Comp [503999901] | $38 - $256 | 94% |
| Humana | $38 - $39 | 94% |
| Aetna | $38 - $108 | 94% |
| Lasso Healthcare [503999926] | $38 | 94% |
| Agency [50311255] | $38 | 94% |
| Devoted [503200068] | $38 | 94% |
| Medicare (plans) | $38 - $39 | 94% |
| Blue Cross Blue Shield | $39 - $122 | 97% |
| Allwell [503200078] | $39 | 97% |
| American Health Plans [503200968] | $40 | 99% |
| Oscar [503201609] | $46 | 114% |
| Larned State Hospital [503200090] | $47 | 116% |
| Centurion [5032000966] | $49 | 121% |
| Ambetter / Centene | $65 | 161% |
| Wellfit [503301514] | $72 | 178% |
| Centivo [5032000982] | $72 | 178% |
| 6 Degrees Health [503999050] | $74 - $95 | 183% |
| Health Plan Inc [503999941] | $75 | 186% |
| Alt Wppa [5032000964] | $76 - $96 | 188% |
| Alt Carelon Behavioral Health [503200905] | $80 | 198% |
| Accarent Health [503999034] | $80 | 198% |
| Meritain Health [503200039] | $82 - $134 | 203% |
| Coresource [503200089] | $82 | 203% |
| Coventry [503200022] | $82 - $108 | 203% |
| Occunet [503999930] | $90 | 223% |
| Fort Hays State Student Athletes [5032000960] | $90 | 223% |
| Php [503200005] | $95 - $118 | 235% |
| Allied National [503999937] | $95 | 235% |
| Cerner [503200038] | $96 | 238% |
| Inter-Americas Insurance [503999032] | $96 | 238% |
| Med-Pay [503200040] | $96 | 238% |
| Healthlink [503200007] | $96 - $118 | 238% |
| Geha [503200036] | $96 - $256 | 238% |
| Claimdoc [503301509] | $103 | 255% |
| Multiplan [503200057] | $103 | 255% |
| Aha-Healthcare Preferred [503200050] | $105 | 260% |
| First Health [5032000110] | $105 | 260% |
| Alt Meritain Health [503999911] | $108 | 267% |
| Correct Care Solutions [50311253] | $111 | 275% |
| Ascension Living Hope [503201517] | $111 | 275% |
| Consolidated Billing [50311256] | $111 | 275% |
| Coeur Plan Services [503301517] | $111 | 275% |
| Advanced Medical Pricing Solutions [503301513] | $114 | 282% |
| Orscheln Industries [503201608] | $119 | 294% |
| Empire Plan/Nyship [503200705] | $122 | 302% |
| Alt Lucent Health Solutions [503202603] | $122 | 302% |
| Alt Lineco [5032000976] | $122 | 302% |
| Quiktrip [5032000412] | $127 | 314% |
| Cigna | $127 - $338 | 314% |
| Century Health Solutions [503200054] | $127 | 314% |
| Point Comfort Underwriters [503200018] | $127 | 314% |
| Hchsync Centrus Health Direct [503999916] | $130 - $150 | 322% |
| Wppa [503200056] | $134 | 332% |
| Usa Managed Care [503999030] | $143 | 354% |
| Employers Health Network [503999025] | $143 | 354% |
| Sanford Health Plan [503999027] | $143 | 354% |
| Three Rivers Provider Network [503999029] | $143 | 354% |
| Plan Care America [503999026] | $143 | 354% |
| Medica [503200074] | $216 - $256 | 535% |
| National Assn Letter Carriers [503200019] | $338 | 836% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," the University of Kansas Hospital lists a gross charge of $159.00. While the facility's cash median rate is $32.00, which is significantly lower than the gross charge, commercial insurance negotiated rates vary widely, ranging from $38 to $338 depending on the payer. Notably, the facility's cash price of $32.00 is lower than the national Medicare benchmark of $40.41, suggesting that for patients with high-deductible plans or those without insurance, paying cash upfront could result in substantial savings compared to insurance reimbursement. Patients should verify if their specific plan falls within the $38 to $338 range and consider requesting a prompt-pay discount, which typically reduces the bill by 20% to 50% when paid in full before or shortly after the service.
To maximize potential savings, consumers should request an itemized bill to ensure no services were unbundled or double-charged, as over 80% of hospital bills contain errors. If a patient receives a balance bill for the difference between the negotiated rate and their allowed amount, they may be eligible for a No Surprises Act audit, particularly if the care was provided at an in-network facility. The facility is located in Kansas City, KS, and operates as an Acute Care Hospital under a Government - Hospital District or Authority ownership structure. Given that the cash rate is already below the Medicare benchmark, patients should prioritize confirming their out-of-network status and asking the billing department specifically about self-pay or prompt-pay discounts before scheduling to avoid unexpected costs.