CMS Price Transparency Data

Prosthetic fitting and training

Facility: Deaconess Henderson Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $101
Cash Discount Price: $50
vs. Medicare Baseline: 2.50x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Deaconess Henderson Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.50x the Medicare baseline. Located in 1305 N Elm St, Henderson, KY.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $50 (124%)

Insurance Median: $101 (250%)

Cash: $50 (124% of Medicare)

Ins. Median: $101 (250% of 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 250% of the Medicare baseline (a markup of 150%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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	$28	69%
Aetna	$30 - $163	74%
Humana	$34 - $134	84%
Medicaid / KanCare	$34	84%
UnitedHealthcare	$34 - $117	84%
Ky Racing Health & Welfare Fund	$49	121%
Mytru Advantage	$49	121%
Self-Pay	$50	124%
Alliance Coal	$57	141%
Amish And Mennonite Of Western Ky	$57	141%
One Care	$76	188%
Encircle/Encore Prime	$85 - $91	210%
Iu Health Plans	$86	213%
Encircle/Encore Combined	$93 - $97	230%
Claimdoc	$101	250%
Hstechnology	$101	250%
Cigna	$108 - $109	267%
Healthlink	$126 - $128	312%
Coventry National Network	$134	332%
Webster County Detention Center	$134	332%
First Health Network (Coventry)	$143	354%
Sagamore	$148 - $150	366%
Henderson County Detention Center	$151	374%
Center Care Narrow	$153	379%
Center Care Open Access	$153	379%
Phcs/Multiplan	$153	379%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $50.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97761.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Deaconess Henderson Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97761.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.