CMS Price Transparency Data

Prosthetic fitting and training

Facility: University of Michigan Health System

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $170
Cash Discount Price: $96
vs. Medicare Baseline: 4.21x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at University of Michigan Health System is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 4.21x the Medicare baseline. Located in 1500 E Medical Center Drive, Spc 5474, Ann Arbor, MI.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$170

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: $96 (238%)

Insurance Median: $170 (421%)

Cash: $96 (238% of Medicare)

Ins. Median: $170 (421% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 421% of the Medicare baseline (a markup of 321%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Point Comfort Underwriters Unaccompanied Children Program	$98 - $109	243%
Priority Health [1038]	$104 - $166	257%
Metrocare	$107 - $119	265%
Medicaid / KanCare	$114 - $127	282%
UnitedHealthcare	$118 - $185	292%
Hap [1023]	$125 - $190	309%
Aetna	$130 - $178	322%
Confinity Advantage	$131 - $147	324%
Plain Church Group	$136 - $152	337%
Beaumont Health Network	$159 - $178	393%
Mclaren Health Plan Inc	$159 - $178	393%
Nomi Health	$159 - $178	393%
Provider Network Of America	$159 - $178	393%
First Agency	$170 - $190	421%
Parkview Health Plan Services	$170 - $190	421%
Cofinity	$173 - $194	428%
Blue Care Network Of Michigan	$177	438%
Blue Cross Blue Shield	$177	438%
Paramount Health Care	$188 - $211	465%
Bronson Healthcare Group	$193 - $216	478%
First Health	$193 - $216	478%
Multiplan	$193 - $216	478%
Priority Health	$241 - $270	596%

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 $96.
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 University of Michigan Health System 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.