Prosthetic fitting and training
Facility: Labette Health
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $52
- Cash Discount Price: $48
- vs. Medicare Baseline: 1.29x 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 |
|---|---|---|
| Ambetter / Centene | $17 - $60 | 42% |
| Uhccp | $18 | 45% |
| Medicaid / KanCare | $20 - $52 | 49% |
| Healthy Blue | $21 | 52% |
| Montgomery County | $23 | 57% |
| Blue Cross Blue Shield | $50 - $52 | 124% |
| Humana | $52 | 129% |
| UnitedHealthcare | $52 - $59 | 129% |
| Wellcare | $52 | 129% |
| Multiplan | $58 | 144% |
| Choicecare (First Health Network) | $62 | 153% |
| Health Partners Of Kansas, Inc | $62 | 153% |
Consumer Guidance & Cost Commentary
For CPT code 97761, "Prosthetic fitting and training," Labette Health in Parsons, KS, lists a cash median price of $48.00, which is lower than the facility's gross charge of $68.00. While the facility is a government-owned acute care hospital, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead. For instance, UnitedHealthcare and Blue Cross Blue Shield have negotiated ranges starting at $50.00 and $52.00 respectively, meaning patients with high-deductible plans might save money by paying the cash price directly, provided they qualify for self-pay or prompt-pay discounts. It is crucial to verify these discounts with the hospital before scheduling, as waiting until after an insurance claim is processed can void the agreement to pay out-of-network or cash rates.
This service is subject to federal protections against surprise billing under the No Surprises Act, which prevents balance billing for out-of-network providers at in-network facilities. However, patients should still request a detailed, itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. When evaluating the cost, it is more accurate to compare the facility's rates against the Medicare benchmark of $40.41 rather than the inflated chargemaster list price, as Medicare rates represent the true cost of delivery. The facility's cash rate of $48.00 is approximately 19% higher than the Medicare amount, while the median negotiated rate across payers sits at $52.00, reflecting the typical markup found in commercial contracts.