CMS Price Transparency Data
Prosthetic fitting and training
Facility: Trinity Health Livingston Hospital
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $132
- Cash Discount Price: $118
- vs. Medicare Baseline: 3.27x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Trinity Health Livingston Hospital is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 3.27x the Medicare baseline. Located in 620 Byron Rd, Howell, MI.
Cash / Self-Pay
$118
Average discount available for prompt cash payment at this facility.
Insurance Median
$132
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: $118 (292%)
Insurance Median: $132 (327%)
Cash: $118 (292% of Medicare)
Ins. Median: $132 (327% 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 327% of the Medicare baseline (a markup of 227%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $21 - $65 | 52% |
| Medicaid / KanCare | $21 - $22 | 52% |
| Huron Valley Pace | $37 | 92% |
| Aetna | $38 - $122 | 94% |
| Blue Care Network Advantage | $38 | 94% |
| Hospice Of Lansing | $38 | 94% |
| Medicare (plans) | $38 - $39 | 94% |
| Align Senior Care | $39 | 97% |
| Angela Hospice | $40 | 99% |
| UnitedHealthcare | $40 - $163 | 99% |
| Wc Accident Fund | $40 | 99% |
| Wc Advantage | $40 | 99% |
| Wc Aig | $40 | 99% |
| Wc Allied | $40 | 99% |
| Wc Amerisure | $40 | 99% |
| Wc Amtrust | $40 | 99% |
| Wc Asu Risk Mgt | $40 | 99% |
| Wc Berkley Admin | $40 | 99% |
| Wc Broadspire | $40 | 99% |
| Wc Bunch & Associates | $40 | 99% |
| Wc Ccmsi | $40 | 99% |
| Wc Emc Insurance Company | $40 | 99% |
| Wc Esis | $40 | 99% |
| Wc Fcci | $40 | 99% |
| Wc Federated | $40 | 99% |
| Wc Gallagher Bassett | $40 | 99% |
| Wc Genex Care For Ohio | $40 | 99% |
| Wc Guard Insurance Company | $40 | 99% |
| Wc Hartford | $40 | 99% |
| Wc Liberty Mutual | $40 | 99% |
| Wc Meijers | $40 | 99% |
| Wc Michigan | $40 | 99% |
| Wc Mitchell Frankenmuth | $40 | 99% |
| Wc Pma | $40 | 99% |
| Wc Sedgwick | $40 | 99% |
| Wc Sentry | $40 | 99% |
| Wc Travelers | $40 | 99% |
| Wc Tristar | $40 | 99% |
| Wc Walmart | $40 | 99% |
| Wc Zurich | $40 | 99% |
| Cca - Zing Health | $41 | 101% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $44 | 109% |
| Molina Marketplace | $50 | 124% |
| Health Cost Solutions | $60 | 148% |
| Priority Health | $60 - $67 | 148% |
| Vitalcore | $60 | 148% |
| Wellpath | $60 | 148% |
| U Of M Health Plan | $62 | 153% |
| Bcn Domestic | $65 | 161% |
| Blue Benefit Administrators Of Massachusetts | $65 | 161% |
| Blue Care Network | $65 | 161% |
| Blue Distinction Transplant | $65 | 161% |
| Blue Shield - Ca | $65 | 161% |
| Blue Shield - Id (Regence) | $65 | 161% |
| Blue Shield - Ny Highmark Northeastern | $65 | 161% |
| Blue Shield - Ny Highmark Western | $65 | 161% |
| Blue Shield - Pa (Highmark) | $65 | 161% |
| Blue Shield - Wa (Regence) | $65 | 161% |
| Health Choices | $65 - $147 | 161% |
| Kaiser Domestic | $65 | 161% |
| Acs Benefit Services | $85 | 210% |
| Allied Benefit Systems | $85 | 210% |
| Asr Health Benefits | $85 | 210% |
| Caresource | $85 | 210% |
| Claimchoice Adminstrators | $85 | 210% |
| Consociate | $85 | 210% |
| Cypress Benefit Administrators | $85 | 210% |
| Forest County Potawatomi | $85 | 210% |
| Hap | $85 - $140 | 210% |
| Health Smart | $85 | 210% |
| Healthgram | $85 | 210% |
| Healthscope | $85 | 210% |
| Secureone Preferred United Plans | $85 | 210% |
| Sisco Benefits | $85 | 210% |
| The Health Plan | $85 | 210% |
| Trustmark Small Business Benefits | $85 | 210% |
| Unified Group Services | $85 | 210% |
| Varipro | $85 | 210% |
| Webtpa | $85 | 210% |
| Employee Benefit Logistic | $87 | 215% |
| Geha | $122 - $132 | 302% |
| Meritain | $122 | 302% |
| Hospice Advantage | $127 | 314% |
| 1199 National Benefit Fund | $139 | 344% |
| Allied National Global Care | $139 | 344% |
| Asrm - Reliance Standard Life Insurance | $139 | 344% |
| Christian Care Ministry | $139 | 344% |
| Dean Health | $139 | 344% |
| Fallon Health | $139 | 344% |
| Family Life Insurance Company | $139 | 344% |
| Ghc Scw | $139 | 344% |
| Group Pension Administrators | $139 | 344% |
| International Benefit Administrators | $139 | 344% |
| Lifetime Benefit Solutions | $139 | 344% |
| Manhattan Life | $139 | 344% |
| Medi Share | $139 | 344% |
| Multiplan | $139 | 344% |
| Mvp | $139 | 344% |
| Pai | $139 | 344% |
| Pan-American Life | $139 | 344% |
| Paramount Hmo | $139 | 344% |
| Phcs | $139 | 344% |
| Trinity Health Share | $139 | 344% |
| Health Partners | $140 | 346% |
| Tufts Health Plan | $140 | 346% |
| Cigna | $141 | 349% |
| Prime Health Services | $145 | 359% |
| Access Health | $147 | 364% |
| Acclaim | $147 | 364% |
| Administrative Concepts | $147 | 364% |
| Allegeant | $147 | 364% |
| Ameriben | $147 | 364% |
| American Family | $147 | 364% |
| American Healthcare Alliance | $147 | 364% |
| American National | $147 | 364% |
| American Republic | $147 | 364% |
| Amerihealth | $147 | 364% |
| Aultcare | $147 | 364% |
| Automated Benefit Services | $147 | 364% |
| Auxiant | $147 | 364% |
| Benefit Administrative Systems,Llc | $147 | 364% |
| Boon Chapman | $147 | 364% |
| Cam Administrative Services | $147 | 364% |
| Christian Brother Services | $147 | 364% |
| Christian Brothers Holy Cross | $147 | 364% |
| Comprehensive Benefits | $147 | 364% |
| Continental Life Insurance | $147 | 364% |
| Coventry | $147 | 364% |
| Custom Benefit Administrators | $147 | 364% |
| Employee Benefit Concepts | $147 | 364% |
| Employee Benefit Management | $147 | 364% |
| Enterprise Group Planning | $147 | 364% |
| Freedom Life Insurance Company | $147 | 364% |
| Group Administrators | $147 | 364% |
| Group Marketing Services | $147 | 364% |
| Guardian | $147 | 364% |
| Health America | $147 | 364% |
| Healthcare Management Admin | $147 | 364% |
| Healthez | $147 | 364% |
| Humana | $147 | 364% |
| Insight | $147 | 364% |
| Intercare | $147 | 364% |
| Jfp Benefit Management | $147 | 364% |
| Jp Farley Corporation | $147 | 364% |
| Key Benefit Administrator | $147 | 364% |
| Liberty Union Life Assurance Co | $147 | 364% |
| Lucent Health | $147 | 364% |
| Luminare Health | $147 | 364% |
| Luminare Health (Detroit) | $147 | 364% |
| Magnacare | $147 | 364% |
| Medben | $147 | 364% |
| Medcost | $147 | 364% |
| Medical Mutual | $147 | 364% |
| Mutual Health Services | $147 | 364% |
| Mutual Of Omaha | $147 | 364% |
| Ncas | $147 | 364% |
| Nippon Life Ins | $147 | 364% |
| Nova | $147 | 364% |
| Painters Union Insurance Fund | $147 | 364% |
| Physicians Mutual | $147 | 364% |
| Plumbers Local 98 Insurance Fund | $147 | 364% |
| Prairie States | $147 | 364% |
| Preferred One | $147 | 364% |
| Primary Physician Care | $147 | 364% |
| Professional Benefit Administrators | $147 | 364% |
| Siho Insurance Services | $147 | 364% |
| The Loomis Company | $147 | 364% |
| Unicare | $147 | 364% |
| Us Health And Life | $147 | 364% |
| Valenz | $147 | 364% |
| Western & Southern Financial Group | $147 | 364% |
| Wps | $147 | 364% |
| First Health | $151 | 374% |
| Correctional Healthcare Consultants | $160 | 396% |
| Three Rivers Provider Network | $163 | 403% |
| Cmh Washtenaw County | $181 | 448% |