Prosthetic fitting and training
Facility: Great Plains Of Sabetha
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $69
- Cash Discount Price: $72
- vs. Medicare Baseline: 1.71x 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 |
|---|---|---|
| Celtic Mcr Adv | $36 - $38 | 89% |
| Aetna | $36 - $75 | 89% |
| Celtic Comm Exchange-All Other Plans | $45 - $48 | 111% |
| Great West Healthcare-All Plans | $59 - $63 | 146% |
| UnitedHealthcare | $64 - $74 | 158% |
| Humana | $66 - $70 | 163% |
| Multiplan-Phcs-All Plans | $66 - $70 | 163% |
| Century/Wppa/Providers-All Plans | $66 - $70 | 163% |
| Federated Mutual Ins-All Plans | $66 - $71 | 163% |
| Cigna | $66 - $70 | 163% |
| Medicaid / KanCare | $69 - $74 | 171% |
| Blue Cross Blue Shield | $69 - $74 | 171% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Great Plains Of Sabetha in Sabetha, KS, lists a cash median price of $72.00, which matches the facility's gross charge. This cash rate is notably higher than the state of Kansas average, where the median paid amount is $66.00. While commercial payers negotiate rates ranging from $36 to $75 depending on the plan, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance negotiated rate exceeds $72.00. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
The facility's negotiated rates vary significantly across insurers, with the lowest allowed amount at $36.00 for Celtic Mcr Adv plans and the highest at $74.00 for Medicaid/KanCare and Blue Cross Blue Shield plans. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur for ancillary services if not carefully reviewed. Before finalizing payment, consumers should demand a full itemized billing audit to verify that all CPT codes correspond to services actually rendered and to identify any unbundled charges or errors, as over 80% of hospital bills contain inaccuracies. Comparing these specific facility rates to the state average provides a clear benchmark for understanding the markup applied to this essential service.