CMS Price Transparency Data

Prosthetic fitting and training

Facility: Lake Charles Memorial Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $40
Cash Discount Price: $59
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Lake Charles Memorial Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.99x the Medicare baseline. Located in 1701 Oak Park Blvd, Lake Charles, LA.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $59 (146%)

Insurance Median: $40 (99%)

Cash: $59 (146% of Medicare)

Ins. Median: $40 (99% 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	$20 - $139	49%
Medicaid / KanCare	$20	49%
Blue Cross Blue Shield	$39	97%
Champus_Va	$39	97%
Cigna	$39 - $74	97%
Medicare (plans)	$39	97%
Tricare	$39	97%
Veterans_Administration	$39	97%
Veterans_Choice-Triwest	$39	97%
Humana	$40 - $138	99%
Meritain	$44	109%
Verity	$47	116%
Ppo_Plus_	$59	146%
Phcs	$69	171%
United_Healthcare_Behavorial_Health	$69	171%
Coushatta_Tribe_Dept_Of_Health	$71	176%
Lwcc	$75	186%
First_Health	$79	195%
Blue_Cross_Blue_Shield_La	$83	205%
Workers_Compensation	$89	220%
Vantage_Commercial	$90	223%
United_Healthcare	$191	473%

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 $59.
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 Lake Charles 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.