Prosthetic fitting and training
Facility: Overland Park Reg Med Ctr
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $74
- Cash Discount Price: $425
- vs. Medicare Baseline: 1.83x 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 |
|---|---|---|
| United | $20 - $191 | 49% |
| Amerigroup | $20 | 49% |
| Medicaid / KanCare | $21 | 52% |
| Aetna | $21 - $217 | 52% |
| Unicare | $21 | 52% |
| Healthyblue | $21 | 52% |
| Home State Health Plan | $37 | 92% |
| Blue Cross Blue Shield | $38 - $183 | 94% |
| Triwest Health Alliance | $38 | 94% |
| Coventry | $38 - $171 | 94% |
| Devoted Health | $38 | 94% |
| Humana | $38 - $86 | 94% |
| Wellcare | $39 | 97% |
| Celtic | $39 | 97% |
| Cigna | $39 | 97% |
| Pyramid Life | $41 | 101% |
| Multiplan | $44 - $315 | 109% |
| Corvel Corporation | $52 - $276 | 129% |
| Oha Network | $54 - $213 | 134% |
| Ambetter / Centene | $79 | 195% |
| Oscar | $81 | 200% |
| Nhc Advantage | $81 | 200% |
| Wppa Providrs Care Network | $85 | 210% |
| Universal Healthcare | $149 | 369% |
| Coventry Kc Mo | $174 | 431% |
| College Park Family Care Center | $183 | 453% |
| Focus Healthcare Mgmt, Inc | $319 | 789% |
| Cco, Inc. | $319 | 789% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," the facility's cash median price is $425.00, which matches the cash median for this service in Kansas. While the facility's gross charge is $425.00, commercial insurance negotiated rates vary significantly, ranging from a low of $20.00 with United to a high of $319.00 with Focus Healthcare Mgmt, Inc. and Cco, Inc. Notably, the median negotiated rate across all payers is $74.00, which is substantially lower than the cash price. For patients with high-deductible plans or those without insurance, paying the cash price of $425.00 directly may be more cost-effective than relying on insurance, as many commercial contracts exceed the cash rate. Patients should verify their specific plan's allowed amount before scheduling, as in-network rates can differ widely between carriers.
To ensure you are receiving the most accurate and fair pricing, it is recommended to request an itemized billing audit before finalizing payment. Hospitals often issue summary bills that obscure individual charges, making it difficult to identify errors or unbundled services; a detailed line-by-line review can help prevent overcharging. Additionally, while the facility offers a cash median of $425.00, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce costs by 20% to 50% if paid in full upfront. This practice bypasses costly administrative claims processing and provides immediate liquidity to the facility. Finally, remember that the No Surprises Act protects patients from balance billing for out-of-network