CMS Price Transparency Data
Prosthetic fitting and training
Facility: Claiborne Memorial Medical Center
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $40
- Cash Discount Price: $45
- vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Claiborne Memorial Medical Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.99x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$45
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: $45 (111%)
Insurance Median: $40 (99%)
Cash: $45 (111% 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.
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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 | $16 - $37 | 40% |
| Commercial Insurance | $16 - $50 | 40% |
| Meritain Health | $16 - $32 | 40% |
| Amerihealth Caritas La | $17 - $21 | 42% |
| Community Health Solution | $17 - $21 | 42% |
| Correctcare Intergrated | $17 - $21 | 42% |
| Healthy Blue | $17 - $21 | 42% |
| Humana | $17 - $50 | 42% |
| Louisiana Hc Connections | $17 - $21 | 42% |
| Magellan Services | $17 - $21 | 42% |
| Medicaid / KanCare | $17 - $21 | 42% |
| UnitedHealthcare | $17 - $37 | 42% |
| Coventry Healthcare | $24 - $30 | 59% |
| Geha | $28 - $35 | 69% |
| Health Plus Of La | $28 - $38 | 69% |
| Apwu Healthplan | $30 - $38 | 74% |
| Cigna | $30 - $38 | 74% |
| Great West Healthcare | $30 - $38 | 74% |
| Phcs | $32 - $40 | 79% |
| Ppo Plus | $32 - $40 | 79% |
| Sedgwick Claims Mgmt Serv | $35 - $45 | 87% |
| Workman'S Comp | $35 - $45 | 87% |
| Arcadian Community Mcr Hm | $37 | 92% |
| Blue Cross Blue Shield | $37 - $115 | 92% |
| Champus | $37 | 92% |
| Champva | $37 | 92% |
| Healthy Blue Dual Adv | $37 | 92% |
| Kaiser Foundation Health | $37 | 92% |
| Medicare (plans) | $37 | 92% |
| Peoples Health Network | $37 | 92% |
| Pyramid Claims Mcr Hmo | $37 | 92% |
| Sterling Connect 2 | $37 | 92% |
| Sterling Premier Mc Hmo | $37 | 92% |
| Superior Health Mcr Hmo | $37 | 92% |
| Tenet Mcr Hmo | $37 | 92% |
| Tricare | $37 | 92% |
| United Hc Mcr Hmo | $37 | 92% |
| Universal Hc Mcr Hmo | $37 | 92% |
| Us Dept Of Labor | $37 | 92% |
| Vantage Health Mcr Hmo | $37 | 92% |
| Windsor Sterling Mcr Hmo | $37 | 92% |
| Wps Mvh Vapc3 | $37 | 92% |
| Aarp | $40 - $50 | 99% |
| Accordia National | $40 - $50 | 99% |
| Aflac | $40 - $50 | 99% |
| Alameda Alliance Forhealt | $40 - $50 | 99% |
| American Pioneer | $40 - $50 | 99% |
| Benefit Management | $40 - $50 | 99% |
| Benesys Inc | $40 - $50 | 99% |
| Business Guarantor | $40 - $50 | 99% |
| Chubb | $40 - $50 | 99% |
| Commercial Sr. Care | $40 - $50 | 99% |
| Employee Benefit Services | $40 - $50 | 99% |
| Family Life Insurance Co | $40 - $50 | 99% |
| Farm Bureau Insurance | $40 - $50 | 99% |
| Fiserv Health Benefit | $40 - $50 | 99% |
| Gmp | $40 - $50 | 99% |
| Group And Pension Admin | $40 - $50 | 99% |
| Group Resources | $40 - $50 | 99% |
| Haik Minvielle And Grubbs | $40 - $50 | 99% |
| Harrington Benefit Svs | $40 - $50 | 99% |
| Health Design Plus | $40 - $50 | 99% |
| Health Plan | $40 - $50 | 99% |
| Healthscope Benefits | $40 - $50 | 99% |
| Insurance Management Admi | $40 - $50 | 99% |
| Jefferson National | $40 - $50 | 99% |
| John Alden Health Ins | $40 - $50 | 99% |
| John Hancock | $40 - $50 | 99% |
| Liberty Mutual | $40 - $50 | 99% |
| Mailhandlers Benefit Plan | $40 - $50 | 99% |
| Manhattan Life Ins Co | $40 - $50 | 99% |
| Mega Life And Health | $40 - $50 | 99% |
| Msa Careguard | $40 - $50 | 99% |
| Mutual Of Omaha | $40 - $50 | 99% |
| Nalc Health Benefit Plan | $40 - $50 | 99% |
| Naphcare Inc. | $40 - $50 | 99% |
| New Era Life Ins Co | $40 - $50 | 99% |
| Physicians Mutual | $40 - $50 | 99% |
| Principal Financial Group | $40 - $50 | 99% |
| Prudential Healthcare | $40 - $50 | 99% |
| Self Pay | $40 - $50 | 99% |
| State Farm | $40 - $50 | 99% |
| State Farm Insurance | $40 - $50 | 99% |
| State Mutual Insurance Co | $40 - $50 | 99% |
| Sterling Investors Life | $40 - $50 | 99% |
| Tower Life | $40 - $50 | 99% |
| Transamerica Premier Ins | $40 - $50 | 99% |
| United American | $40 - $50 | 99% |
| United Comm Travelers | $40 - $50 | 99% |
| United Teachers | $40 - $50 | 99% |
| Usable Administrator | $40 - $50 | 99% |
| Visn 16 Cfu | $40 - $50 | 99% |
| Wausau Benefits | $40 - $50 | 99% |
| Webtpa | $40 - $50 | 99% |
| Wells Fargo | $40 - $50 | 99% |
| Woodmen Of The World | $40 - $50 | 99% |
| Vantage Health Plan Inc | $41 - $46 | 101% |