CMS Price Transparency Data

Prosthetic fitting and training

Facility: Buffalo Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $114
Cash Discount Price: $81
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Buffalo Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.82x the Medicare baseline. Located in 303 Catlin Street, Buffalo, MN.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $81 (200%)

Insurance Median: $114 (282%)

Cash: $81 (200% of Medicare)

Ins. Median: $114 (282% 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 282% of the Medicare baseline (a markup of 182%). 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
Ucare Pmap (A B C D E G N O S U R H)	$29	72%
Medicaid / KanCare	$32	79%
South Country Health Alliance	$33	82%
Aetna	$38 - $86	94%
Medicare (plans)	$40	99%
Blue Cross Blue Shield	$42 - $280	104%
Medica	$42 - $253	104%
Health Partners	$95 - $139	235%
Healthpartners	$98	243%
Americas Ppo (Araz)(B D N O R S V)	$112	277%
Medica Ub Health (B)	$116	287%
Americas Ppo (Araz) (B D N H O R S)	$122	302%
First Health (A C E G H U B D N O R S)	$122	302%
All Other Contracted Care (A B C D E G H N O R S U)	$146	361%
Medica Health System	$160 - $266	396%
Medica Mhps	$253	626%
UnitedHealthcare	$311	770%

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 $81.
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 Buffalo 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.