CMS Price Transparency Data

Prosthetic fitting and training

Facility: North Adams Regional Hospital Corporation

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 North Adams Regional Hospital Corporation 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 71 Hospital Avenue, North Adams, 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
Blue Cross Blue Shield $20 - $75 49%
Comm Hospice $20 - $42 49%
Mcr Miscellaneous $20 - $42 49%
Mcrmanaged Cca One Care $20 - $47 49%
Mcrmanaged Usa Family $20 - $42 49%
Mcrmanaged Va $20 - $42 49%
Medicaid / KanCare $20 - $147 49%
Medicare (plans) $20 - $44 49%
Oth United Vaccn $20 - $42 49%
Mcd Masshealth $32 - $147 79%
Mcd New York $32 - $73 79%
Mcd Out Of State $32 - $147 79%
Mcdmanaged Cdphp $32 - $147 79%
Mcdmanaged Hne Mcdaco $32 - $147 79%
Tricare $33 - $42 82%
Comm Network Qhpsub $35 - $50 87%
Mcdmanaged Network $35 - $50 87%
Mcdmanaged Bmchnp $37 - $153 92%
Aetna $49 - $66 121%
Comm Fallon Qhp $50 - $63 124%
Wc Workers Comp $53 131%
Comm Network Qhpnonsub $56 - $63 139%
Comm Nhp $57 141%
Comm Unicare $57 - $70 141%
Comm Hne Hmo $61 - $79 151%
Comm Hne $64 - $84 158%
Comm Hne Ppo $64 - $84 158%
Comm Tufts $70 173%
UnitedHealthcare $76 188%
Cigna $79 - $82 195%
Comm Cdphp $79 195%
Comm Mvp $79 195%
Comm Oxford $79 195%
Comm First Health $82 - $84 203%
Comm Connecticare $84 208%
Comm Consolidated Health $84 208%
Comm Harvard $84 208%
Comm Other $84 208%
Comm Phcs $84 208%
Comm Self Pay $84 208%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals