CMS Price Transparency Data

Prosthetic fitting and training

Facility: Breckinridge Memorial Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $52
Cash Discount Price: $64
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Breckinridge Memorial Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.29x the Medicare baseline. Located in 1011 Old Highway 60, Hardinsburg, KY.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $64 (158%)

Insurance Median: $52 (129%)

Cash: $64 (158% of Medicare)

Ins. Median: $52 (129% 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.

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
Aetna	$19 - $112	47%
Blue Cross Blue Shield	$19 - $150	47%
Wellcare Mcaid - All Other Plans	$19	47%
Tricare	$34 - $49	84%
Molina Mcr Adv - All Plans	$36 - $52	89%
University Health Care - All Other Plans	$37 - $52	92%
Caresource - All Plans	$38 - $54	94%
UnitedHealthcare	$38 - $128	94%
University Health Care Mcr Adv	$38 - $54	94%
Wellcare Mcr Adv	$38 - $54	94%
Ambetter / Centene	$42 - $59	104%
Humana	$79 - $112	195%

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 $64.
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 Breckinridge Memorial 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.