Prosthetic fitting and training
Facility: Neosho Memorial Regional Medical Center
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $50
- Cash Discount Price: $117
- vs. Medicare Baseline: 1.24x 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 | $20 | 49% |
| Tricare | $48 | 119% |
| Va_Ccn | $50 | 124% |
| Medicare (plans) | $50 | 124% |
| Blue Cross Blue Shield | $50 - $56 | 124% |
| Humana | $50 | 124% |
| Medadv_Uhc | $50 | 124% |
| Aetna | $50 | 124% |
| Medadv_Allwell | $50 | 124% |
| Ambetter / Centene | $79 | 195% |
| United | $130 | 322% |
| Wppa_Providrscare | $130 | 322% |
| Hpk | $149 | 369% |
| Cigna | $149 | 369% |
| Coventry | $149 | 369% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," Neosho Memorial Regional Medical Center in Chanute, KS, lists a gross charge of $157.00. This facility is a Critical Access Hospital with government-local ownership, and its cash median rate is $117.00. When compared to the state of Kansas, the facility's cash rate is 1.2 times the Medicare benchmark of $40.41. While commercial negotiated rates range from $20 to $149 across 15 different payers, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $117.00. It is important to note that commercial rates often include administrative overhead for claims processing, which can inflate the baseline price by 20% to 40% compared to direct cash payments.
To ensure you are receiving the most accurate pricing, always request a full itemized CPT-coded bill before finalizing payment, as summary bills can obscure individual code costs and potential errors. If you are paying out-of-pocket, ask the billing department specifically about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% for upfront payment. Since this service is covered by multiple insurers including Medicaid/KanCare, Tricare, and various Blue Cross and United plans, verify your specific plan's allowed amount before scheduling to avoid unexpected balance billing. Remember that while in-network status protects you from balance billing for emergency care under the No Surprises Act, it does not guarantee the lowest possible rate, so comparing your plan's negotiated amount