CMS Price Transparency Data

Prosthetic fitting and training

Facility: M Health Fairview University of Mn Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $82
Cash Discount Price: $86
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at M Health Fairview University of Mn Medical Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.03x the Medicare baseline. Located in 2450 Riverside Avenue, Minneapolis, MN.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $86 (213%)

Insurance Median: $82 (203%)

Cash: $86 (213% of Medicare)

Ins. Median: $82 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Itasca Medical Care	$31 - $40	77%
Primewest	$31 - $40	77%
South Country Health Alliance	$31 - $40	77%
Medica	$32 - $136	79%
Health Partners	$33 - $232	82%
Hennepin Health	$33 - $37	82%
Ucare	$33 - $112	82%
Blue Cross Blue Shield	$34 - $191	84%
Sanford Health Plan	$40 - $126	99%
Security Health Plan	$40 - $160	99%
UnitedHealthcare	$40 - $122	99%
Wellcare	$40	99%
America'S Ppo	$111 - $154	275%
Cigna	$120	297%
Emerging Therapies	$137	339%
Humana	$139	344%
Aetna	$146	361%
Interlink	$160	396%
First Health	$175	433%
Multiplan	$182	450%
Private Healthcare Systems	$182	450%
Wisconsin Physician Services	$193	478%

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 $86.
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 M Health Fairview University of Mn 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.