Prosthetic fitting and training
Facility: Menorah Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $54
- Cash Discount Price: $237
- vs. Medicare Baseline: 1.34x 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 |
|---|---|---|
| Amerigroup | $20 | 49% |
| United | $20 - $107 | 49% |
| Unicare | $21 | 52% |
| Aetna | $21 - $121 | 52% |
| Medicaid / KanCare | $21 | 52% |
| Healthyblue | $21 | 52% |
| Blue Cross Blue Shield | $31 - $107 | 77% |
| Home State Health Plan | $37 | 92% |
| Coventry | $38 - $95 | 94% |
| Humana | $38 - $86 | 94% |
| Devoted Health | $38 | 94% |
| Triwest Health Alliance | $38 | 94% |
| Celtic | $39 | 97% |
| Cigna | $39 - $189 | 97% |
| Wellcare | $39 | 97% |
| Pyramid Life | $41 | 101% |
| Ambetter / Centene | $44 | 109% |
| Multiplan | $44 - $175 | 109% |
| Oscar | $45 | 111% |
| Nhc Advantage | $45 | 111% |
| Wppa Providrs Care Network | $47 | 116% |
| Corvel Corporation | $52 - $154 | 129% |
| Oha Network | $54 - $118 | 134% |
| Universal Healthcare | $83 | 205% |
| Coventry Kc Mo | $97 | 240% |
| College Park Family Care Center | $102 | 252% |
| Cco, Inc. | $178 | 440% |
| Focus Healthcare Mgmt, Inc | $178 | 440% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Menorah Medical Center in Overland Park, KS, lists a cash median price of $237.00. This cash rate is significantly higher than the state average, which is 1.3 times the Medicare amount of $40.41. While commercial insurance plans like Aetna, Blue Cross Blue Shield, and Cigna negotiate rates ranging from $20 to $189, these negotiated amounts often exceed the cash price. For patients with high-deductible plans, paying the cash rate of $237.00 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount could result in higher out-of-pocket costs once deductibles are met.
To ensure you are receiving the best possible rate, 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 within a short window, bypassing the administrative overhead associated with insurance claims. While the facility's median negotiated rate is $54.00, this figure represents the contract ceiling for insurers rather than the final amount you will owe; always verify your specific plan's allowed amount and ask for self-pay or prompt-pay options prior to scheduling your appointment to avoid unexpected balance billing.