Prosthetic fitting and training
Facility: Mcpherson Hospital
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $93
- Cash Discount Price: $90
- vs. Medicare Baseline: 2.30x 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 230% of the Medicare baseline (a markup of 130%). 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 |
|---|---|---|
| Tricare | $33 | 82% |
| Healthy Blue Mcr Adv | $38 | 94% |
| Va Ccn - All Plans | $38 | 94% |
| Wellcare Mcr Adv - All Plans | $38 | 94% |
| UnitedHealthcare | $38 - $122 | 94% |
| Blue Cross Blue Shield | $38 | 94% |
| Humana | $38 | 94% |
| Ambetter / Centene | $44 | 109% |
| Wppa - All Plans | $85 | 210% |
| Medical Associates - All Plans | $92 | 228% |
| Central Plains - All Plans | $92 | 228% |
| Christian Health Aid - All Plans | $98 | 243% |
| Aetna | $101 - $122 | 250% |
| Multiplan - All Plans | $110 | 272% |
| Cigna | $116 | 287% |
| First Health - All Plans | $116 | 287% |
| Health Partners - All Plans | $116 | 287% |
| Medicaid / KanCare | $122 | 302% |
| Health Blue Mcaid - All Other Plans | $124 | 307% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," McPherson Hospital in McPherson, KS, lists a gross charge of $122.00. While the facility offers a cash median price of $90.00, which is lower than the state average of $99.00, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, UnitedHealthcare and Aetna have negotiated ranges that reach up to $122.00, matching the gross charge, whereas Medicaid/KanCare pays the full $122.00. Because commercial rates can sometimes be higher than the cash price, patients with high-deductible plans may find it financially beneficial to pay the cash rate directly, provided they verify the specific negotiated amount with their insurer first.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should inquire about "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims cycle. If you receive a balance bill from an out-of-network provider at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services. Always dispute any unexpected charges in writing rather than accepting summary bills or verbal settlements to protect your rights and minimize medical debt.