Prosthetic fitting and training
Facility: Wesley Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $38
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.94x 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 |
|---|---|---|
| UnitedHealthcare | $20 | 49% |
| Amerigroup | $21 | 52% |
| Aetna | $21 - $200 | 52% |
| Medicaid / KanCare | $21 | 52% |
| Triwest Health Alliance | $38 | 94% |
| Devoted Health | $38 | 94% |
| Coventry Health Care | $38 | 94% |
| Humana | $38 | 94% |
| United | $39 | 97% |
| Ambetter / Centene | $40 | 99% |
| Blue Cross Blue Shield | $42 | 104% |
| First Health | $52 | 129% |
| Multiplan | $54 | 134% |
| Correct Care Solutions | $57 | 141% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," at Wesley Medical Center in Wichita, KS, the facility's negotiated rates range from $20 to $200 depending on the insurance carrier. The median negotiated rate across all payers is $38.00, which is significantly lower than the state average of $52.00. While the facility's cash median is not listed, patients with high-deductible plans should be aware that paying cash upfront can sometimes be cheaper than the insurance negotiated rate if the insurer's allowed amount exceeds the cash price. It is crucial to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can reduce the total cost by bypassing administrative billing cycles.
The Medicare benchmark for this service is $40.41, which serves as a reliable baseline for evaluating the facility's pricing markup. The facility's negotiated rates are generally aligned with or below this benchmark, with the lowest negotiated rate of $20 and the highest of $200 observed across different payers. Since Medicare rates represent the true cost of care delivery, comparing them to the facility's commercial rates helps identify potential overcharges. Patients should avoid relying on summary bills and instead request a detailed, itemized statement to ensure no unbundled codes or services not rendered are included. If a balance bill arises from an out-of-network provider at this in-network facility, the No Surprises Act may protect the patient from paying the difference, so disputes should be handled in writing rather than accepted immediately.