Prosthetic fitting and training
Facility: Kansas Medical Center Llc
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $38
- Cash Discount Price: $58
- 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 |
|---|---|---|
| Medicaid / KanCare | $20 | 49% |
| Indian Health | $34 | 84% |
| Tricare | $34 | 84% |
| Medadv_Wellcare | $38 | 94% |
| Humana | $38 | 94% |
| Blue Cross Blue Shield | $38 - $48 | 94% |
| Ambetter / Centene | $38 | 94% |
| Wppa | $39 | 97% |
| Aetna | $63 | 156% |
| Three_Rivers | $76 | 188% |
| United | $85 | 210% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Kansas Medical Center Llc in Andover, KS, lists a cash median price of $58.00, which is lower than the facility's negotiated rates ranging from $34 to $85 across 11 payers. While the facility's cash price is competitive, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $58.00 median could be lower than their insurance allowed amount. However, before scheduling, it is crucial to verify your specific plan's deductible status and confirm whether the facility offers "self-pay" or "prompt-pay" discounts that could further reduce the final cost.
This service is benchmarked against the Medicare rate of $40.41, which serves as a scientifically validated baseline for the true cost of care. The facility's cash price of $58.00 represents a markup relative to this federal standard, while the lowest negotiated rate of $34.00 (seen with Medicaid/KanCare, Indian Health, Tricare, and others) falls below the Medicare amount. When reviewing your bill, ensure you receive an itemized statement rather than a summary invoice to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. If you receive a balance bill for out-of-network ancillary services, you may be entitled to protections under the No Surprises Act, which bans surprise billing for emergency care and non-emergency services at in-network facilities.