CMS Price Transparency Data

Prosthetic fitting and training

Facility: Essentia Health Ada

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $72
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Essentia Health Ada is $72. 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 1.78x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.
Cash / Self-Pay
$81

Average discount available for prompt cash payment at this facility.

Insurance Median
$72

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: $72 (178%)
Cash: $81 (200% of Medicare)
Ins. Median: $72 (178% 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.

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 Med Care $41 101%
Healthpartners Care Pmap $42 104%
Primewest $42 104%
Medica Access $43 - $68 106%
Sanford Health Plan $47 - $49 116%
Advocare/Security Health $52 129%
Blue Cross Blue Shield $52 - $95 129%
Freedom Blue Ppo $52 129%
Healthpartners Care Msho / Mcr Adv $52 129%
Imcare Msho Pcc Prime $52 129%
Imcare Msho Ref Req $52 129%
Medica Advantage Solutions $52 129%
Medica Msho/Dual Solutions $52 129%
Medica Prime Solution Group $52 129%
Medicare (plans) $52 129%
Nd Va Administration $52 129%
Platinum Blue/Vantage Blue $52 129%
Primewest Msho $52 129%
Secure Blue Msho $52 129%
Ubh Cost Plan $52 129%
Ubh Msho $52 129%
Ucare Msho $52 129%
UnitedHealthcare $52 - $99 129%
Blue Plus Pmap Pcc Prime $60 - $95 148%
Healthpartners $66 - $72 163%
Cigna $72 178%
Healthpartners Pcc Prime $72 178%
Ucare $72 178%
Wea $78 - $84 193%
America'S Ppo $84 208%
Wps $90 - $92 223%
Medica $91 - $95 225%
Medica Uplan $91 225%
Aetna $93 230%
Medica Choice $98 243%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 9Th Street West, Ada, MN 56510
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals