Prosthetic fitting and training
Facility: Kingman Healthcare Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $136
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.37x 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 337% of the Medicare baseline (a markup of 237%). 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 |
|---|---|---|
| Humana | $136 | 337% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Kingman Healthcare Center in Kingman, KS, has a negotiated rate of $136.00 with Humana. This facility is a Critical Access Hospital with a voluntary non-profit ownership structure. While the data does not provide specific cash or median paid values for this service, patients should be aware that cash-pay options can sometimes be more affordable than insurance negotiated rates, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront fee reductions can significantly lower out-of-pocket costs by bypassing administrative processing fees.
When evaluating this cost, it is important to understand that commercial negotiated rates often include administrative overhead and do not represent the true cost of care. Medicare serves as a more reliable benchmark for fair pricing, as it is calculated based on actual provider costs rather than inflated chargemaster lists. Although the data indicates a 3.4x variance versus Medicare, patients should avoid comparing discounts against the hospital's full list price, as this can create a false sense of savings. To ensure transparency and avoid unexpected balance billing, consumers should request a detailed, itemized bill that breaks down every CPT code and charge, allowing them to verify that all services rendered were billed correctly and that no unbundled items or errors have inflated the total.