CMS Price Transparency Data

Prosthetic fitting and training

Facility: Essentia Health Fosston

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 Fosston 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 900 Hilligoss Boulevard Se, Fosston, 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.

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 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	$54	134%
Blue Cross Blue Shield	$54 - $95	134%
Freedom Blue Ppo	$54	134%
Healthpartners Care Msho / Mcr Adv	$54	134%
Imcare Msho Pcc Prime	$54	134%
Imcare Msho Ref Req	$54	134%
Medica Advantage Solutions	$54	134%
Medica Msho/Dual Solutions	$54	134%
Medica Prime Solution Group	$54	134%
Medicare (plans)	$54	134%
Nd Va Administration	$54	134%
Platinum Blue/Vantage Blue	$54	134%
Primewest Msho	$54	134%
Secure Blue Msho	$54	134%
Ubh Cost Plan	$54	134%
Ubh Msho	$54	134%
Ucare Msho	$54	134%
UnitedHealthcare	$54 - $99	134%
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

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 Essentia Health Fosston 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.