Prosthetic fitting and training
Facility: Goodland Regional Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $88
- Cash Discount Price: $88
- vs. Medicare Baseline: 2.18x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 218% of the Medicare baseline (a markup of 118%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Blue Cross Blue Shield | $50 | 124% |
| Wppa | $83 - $88 | 205% |
| UnitedHealthcare | $88 | 218% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Goodland Regional Medical Center lists a cash median price of $88.00, which is notably lower than the facility's negotiated rates of $88.00 to $88.00 for Wppa and UnitedHealthcare plans. While the facility's cash price is competitive, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan, paying the cash price of $88.00 upfront may result in lower out-of-pocket costs compared to your insurance's allowed amount, especially if your deductible has not yet been met. Always ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full within a short window can sometimes reduce the final bill further.
This service is provided at a Critical Access Hospital in Goodland, KS, with a Medicare benchmark of $40.41. The facility's cash rate of $88.00 represents a 2.2x markup relative to the Medicare amount, which is consistent with typical commercial pricing where rates average 200% to 300% of Medicare. Because the facility is a government-owned Critical Access Hospital, patients may encounter balance billing if they are out-of-network, though the No Surprises Act protects against surprise bills for emergency care and non-emergency services at in-network facilities. To ensure accuracy, request a full itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Dis