CMS Price Transparency Data

Prosthetic fitting and training

Facility: Garden City Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $40
Cash Discount Price: $39
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Garden City Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.99x the Medicare baseline. Located in 6245 Inkster Rd, Garden City, MI.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $39 (97%)

Insurance Median: $40 (99%)

Cash: $39 (97% of Medicare)

Ins. Median: $40 (99% 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
Aetna	$21 - $40	52%
Beacon Health Strategies	$21	52%
Harbor Health Plan	$21 - $40	52%
Mclaren Health Plan	$21 - $40	52%
Medicaid / KanCare	$21 - $23	52%
Priority Health	$21	52%
Total Health Care Priority Health	$21 - $40	52%
Blue Cross Blue Shield	$40 - $75	99%
Honest Hmo	$40	99%
Humana	$40	99%
Medicare (plans)	$40	99%
Sunrise	$40	99%
Tricare	$40	99%
UnitedHealthcare	$40	99%
Longevity Hp	$42	104%
Zing	$42	104%
Employer Direct Healthcare	$56	139%
Naphcare Residential Inmate Treatment Center	$62	153%

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 $39.
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 Garden City 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.