Prosthetic fitting and training
Facility: Sheridan County Hospital
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $70
- Cash Discount Price: $94
- vs. Medicare Baseline: 1.73x 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 Insurance | $57 | 141% |
| Blue Cross Blue Shield | $70 | 173% |
| UnitedHealthcare | $89 | 220% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Sheridan County Hospital in Hoxie, KS, lists a cash price of $94.00. This cash rate is significantly higher than the state average, which is $40.41 (Medicare amount). While the facility offers a negotiated rate of $70.00 to in-network insurers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare, these rates remain above the cash price. For patients with high-deductible plans, paying the $94.00 cash price directly may be more cost-effective than relying on insurance, as the negotiated rates exceed the cash amount. Patients should verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final cost.
To ensure you are not overcharged, it is critical to request a full itemized bill rather than accepting a summary invoice. Hospitals often issue broad category totals that obscure individual charges, making it difficult to identify errors such as unbundled codes or services not rendered. Since over 80% of hospital bills contain mistakes, obtaining a detailed line-by-line statement is the most effective way to audit your charges and negotiate a fair price. Additionally, commercial negotiated rates often include administrative overhead, meaning the $70.00 rate paid by insurers may be marked up significantly compared to the true cost of care represented by the Medicare benchmark of $40.41. Always compare your final allowed amount against the Medicare rate to understand the actual markup applied to your service.