CMS Price Transparency Data

Prosthetic fitting and training

Facility: Sanford Worthington Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $78
Cash Discount Price: $114
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Sanford Worthington Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.93x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $114 (282%)

Insurance Median: $78 (193%)

Cash: $114 (282% of Medicare)

Ins. Median: $78 (193% 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
Sanford Health Plan Align	$39	97%
Aetna	$42 - $116	104%
Blue Cross Blue Shield	$42 - $64	104%
Health Partners	$42 - $101	104%
Medicare (plans)	$42	104%
Ucare	$42 - $111	104%
UnitedHealthcare	$42 - $119	104%
Primewest	$43	106%
Sanford Health Plan	$55 - $65	136%
Security Health Plan	$78	193%
Medica	$127 - $136	314%
First Choice Health Network	$128	317%
Healthez	$128	317%
Multiplan	$128	317%

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 $114.
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 Sanford Worthington Medical Center 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.