CMS Price Transparency Data

Prosthetic fitting and training

Facility: Fairview Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $57
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Fairview Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.41x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $84 (208%)
Insurance Median: $57 (141%)
Cash: $84 (208% of Medicare)
Ins. Median: $57 (141% 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.

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 $25 - $66 62%
Health New England $32 - $147 79%
Medicaid / KanCare $32 - $147 79%
Other Government $33 - $42 82%
Blue Cross Blue Shield $34 - $75 84%
Commcare Alliance $34 - $49 84%
Fallon $34 - $44 84%
Hospice $34 - $42 84%
Medicare (plans) $34 - $41 84%
UnitedHealthcare $34 - $76 84%
Point32Health $35 - $84 87%
Bmchnp $37 - $153 92%
Comm Fallon Qhp $54 - $63 134%
Workers Comp $56 139%
Allways Nhp $57 141%
Unicare $57 - $70 141%
Comm Hne Hmo $61 - $79 151%
Comm Hne Ppo $64 - $84 158%
Capital District Physicians' Health Plan $79 195%
Cigna $79 - $82 195%
Mvp $79 195%
Oxford $79 195%
First Health $82 - $84 203%
Connecticare $84 208%
Consolidated Health Plans $84 208%
Other Commercial $84 208%
Phcs $84 208%
Self Pay $84 208%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29 Lewis Avenue, Great Barrington, MA 01230
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals