Prosthetic fitting and training
Facility: Smith County Memorial Hospital
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $59
- Cash Discount Price: $63
- vs. Medicare Baseline: 1.46x 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 | $44 - $63 | 109% |
| Blue Cross Blue Shield | $50 | 124% |
| Multiplan-All Plans | $57 | 141% |
| Wppa-All Plans | $59 | 146% |
| UnitedHealthcare | $60 | 148% |
| Health Partners Of Ks Ppo-All Plans | $60 | 148% |
| Midlands Choice-All Plans | $60 | 148% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Smith County Memorial Hospital in Smith Center, KS, lists a cash price of $63.00, which matches the facility's gross charge and the cash median for this service. This cash rate is notably higher than the state average of $59.00, meaning patients paying out-of-pocket may face costs above the typical negotiated or cash rates found across Kansas. While commercial payers like Medicaid/KanCare and Blue Cross Blue Shield have negotiated rates ranging from $44 to $63, the cash price remains the highest figure in this dataset. Patients with high-deductible plans should consider that paying the full cash price of $63.00 upfront might be more economical than relying on insurance, as the negotiated rates for some plans exceed the cash amount.
To minimize unexpected costs, consumers should verify if the hospital offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can reduce the final bill. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to request an itemized billing audit to identify errors such as unbundled codes or services not rendered, which can significantly lower your debt. Additionally, under the No Surprises Act, you are protected from balance billing for emergency care and non-emergency services at in-network facilities, so any surprise bills should be disputed with your insurer rather than paid immediately. Always compare the facility's rates directly to the Medicare benchmark of $40.41, as this provides a scientifically validated baseline for evaluating the true cost of the service.