CMS Price Transparency Data

Prosthetic fitting and training

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $63
Cash Discount Price: $101
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Munson Healthcare Otsego Memorial Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.56x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $101 (250%)

Insurance Median: $63 (156%)

Cash: $101 (250% of Medicare)

Ins. Median: $63 (156% 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.

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
Blue Cross Blue Shield	$20 - $74	49%
Mclaren Health Plan	$20 - $100	49%
Meridian	$20	49%
Molina	$20 - $42	49%
Priority Health	$20 - $85	49%
UnitedHealthcare	$20 - $95	49%
Blue Care Network	$38	94%
Hap (Health Alliance Plan)	$38 - $95	94%
Humana	$38	94%
Medicare (plans)	$38	94%
Michigan Amish Medical Board	$38	94%
Northern Michigan Mennonite Group	$38	94%
Aetna	$39 - $96	97%
Asr Physicians Care Network	$58 - $95	144%
Nomi Health	$61 - $95	151%
Employee Benefit Logistics	$65	161%
Cigna	$71 - $85	176%
Hospice Of Michigan	$71	176%
Munson Hospice	$83 - $852	205%
Enterprise Group Planning/Employee Benefit Plan	$95	235%
Cofinity	$101	250%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$101	250%
Three Rivers Provider Network	$101	250%

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 $101.
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 Munson Healthcare Otsego Memorial Hospital 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.