CMS Price Transparency Data
Prosthetic fitting and training
Facility: Mercy Hospital Springfield
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $69
- Cash Discount Price: $81
- vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Mercy Hospital Springfield is $69. 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 1.71x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$81
Average discount available for prompt cash payment at this facility.
Insurance Median
$69
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: $69 (171%)
Cash: $81 (200% of Medicare)
Ins. Median: $69 (171% 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 |
|---|---|---|
| Blue Cross Blue Shield | $20 - $214 | 49% |
| Medicaid / KanCare | $20 - $53 | 49% |
| Aetna | $36 - $64 | 89% |
| Centivo Contracted [320505] | $36 | 89% |
| Centurion Of Missouri [20459] | $36 | 89% |
| Champva [20065] | $36 | 89% |
| Cherokee Nation Health Serv Contracted [320066] | $36 | 89% |
| Cigna | $36 - $99 | 89% |
| Cross Timbers Hospice [20098] | $36 | 89% |
| Dept Of Veteran Affairs Contracted [320106] | $36 | 89% |
| Elara Caring Aspire Hospice [20433] | $36 | 89% |
| Globalhealth Contracted [320145] | $36 | 89% |
| Halo Hcr Inc Hospice Contracted [320432] | $36 | 89% |
| Halo Hcr Inc Hospice [20432] | $36 | 89% |
| Humana | $36 - $88 | 89% |
| Indian Health Service Contracted [320198] | $36 | 89% |
| Indian Health Service [20198] | $36 | 89% |
| Kindful Hospice Contracted [320434] | $36 | 89% |
| Kindful Hospice [20434] | $36 | 89% |
| Medicare (plans) | $36 - $40 | 89% |
| Mercy Hospice Okc [20252] | $36 | 89% |
| Mercy Mgd Behavioral Health Contracted [320259] | $36 | 89% |
| Mercy Rehab Hospital Contracted [320260] | $36 | 89% |
| Pace Of The Ozarks Contracted [320518] | $36 | 89% |
| Qual Choice Contracted [320325] | $36 | 89% |
| Tricare | $36 | 89% |
| UnitedHealthcare | $36 - $453 | 89% |
| Provider Partners Health Plans Contracted [320450] | $40 | 99% |
| Healthscope Contracted [320182] | $46 | 114% |
| Benefit Management Contracted [320052] | $48 - $52 | 119% |
| Health Systems Inc Contracted [320174] | $48 - $52 | 119% |
| Insurance System Inc Contracted [320465] | $48 - $52 | 119% |
| Medica Contracted [320239] | $48 - $51 | 119% |
| Medica [20239] | $48 - $51 | 119% |
| Ambetter / Centene | $49 - $52 | 121% |
| Home State Health Plan Contracted [320187] | $49 - $52 | 121% |
| Novasys Contracted [320285] | $49 - $52 | 121% |
| Administrative Payor Contracted [320005] | $54 - $64 | 134% |
| Evolutions Health Care Contracted [320124] | $54 - $58 | 134% |
| Point C Contracted [320238] | $54 - $97 | 134% |
| Point C [20238] | $54 - $58 | 134% |
| Medical Destinations Contracted [320242] | $60 - $64 | 148% |
| Mercy Benefit Admin Contracted [320251] | $60 - $195 | 148% |
| Workers Comp [20426] | $60 - $110 | 148% |
| United Medical Resources Contracted [320454] | $63 - $302 | 156% |
| First Health Contracted [320128] | $68 - $72 | 168% |
| Aither Health Contracted [320449] | $69 - $74 | 171% |
| Auxiant Contracted [320462] | $69 - $84 | 171% |
| Ebms Contracted [320493] | $69 - $74 | 171% |
| Edison Health Solutions Contracted [320502] | $69 - $74 | 171% |
| Healthlink Contracted [320179] | $69 - $103 | 171% |
| Imagine 360 Contracted [320494] | $69 - $74 | 171% |
| Reflect Health Contracted [320492] | $69 - $74 | 171% |
| Yuzu Health Contracted [320521] | $69 - $74 | 171% |
| Providrs Care Network Contracted [320484] | $72 | 178% |
| Federal Medical Center Contracted [320127] | $73 - $77 | 181% |
| Show-Me Health Administrators Contracted [320483] | $73 - $195 | 181% |
| Multiplan Contracted [320270] | $93 - $99 | 230% |
| Private Health Care Systems Contracted [320320] | $93 - $99 | 230% |
| Compcare Of The Ozarks Contracted [320437] | $96 - $102 | 238% |
| American Healthcare Alliance Contracted [320020] | $97 - $103 | 240% |
| Qual Choice Contracted [320324] | $97 - $103 | 240% |
| Municipal Health Plan Contracted [320271] | $98 - $104 | 243% |
| Usa Managed Care Org Contracted [320429] | $106 - $114 | 262% |
| Ppo Plus Contracted [320310] | $109 - $116 | 270% |
| 90 Degree Benefits Contracted [320436] | $195 | 483% |