CMS Price Transparency Data

Prosthetic fitting and training

Facility: Mercy Hospital Southeast

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $52
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Mercy Hospital Southeast is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.29x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $102 (252%)
Insurance Median: $52 (129%)
Cash: $102 (252% of Medicare)
Ins. Median: $52 (129% 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
Aetna $10 - $100 25%
Medicaid / KanCare $10 - $64 25%
Auxiant Contracted [320462] $36 - $73 89%
Blue Cross Blue Shield $36 - $149 89%
Cross Timbers Hospice [20098] $36 89%
Dept Of Veteran Affairs Contracted [320106] $36 89%
Elara Caring Aspire Hospice Contracted [320433] $36 89%
Elara Caring Aspire Hospice [20433] $36 89%
Halo Hcr Inc Hospice Contracted [320432] $36 89%
Halo Hcr Inc Hospice [20432] $36 89%
Healthlink Contracted [320179] $36 - $220 89%
Humana $36 - $133 89%
Imagine 360 Contracted [320494] $36 89%
Kindful Hospice Contracted [320434] $36 89%
Kindful Hospice [20434] $36 89%
Medicare (plans) $36 - $38 89%
Mercy Benefit Admin Contracted [320251] $36 - $107 89%
Mercy Hospice Okc [20252] $36 89%
Pace Of The Ozarks Contracted [320518] $36 89%
Tricare $36 89%
Ambetter / Centene $37 92%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $37 92%
Home State Health Plan Contracted [320187] $37 92%
Hope Trust Contracted [320488] $37 92%
UnitedHealthcare $37 - $55 92%
Provider Partners Health Plans Contracted [320450] $42 104%
Consociate Consolidated Health Contracted [320490] $51 - $82 126%
Centivo Contracted [320505] $61 151%
Ebms Contracted [320493] $61 151%
Preferred Health Plan Contracted [320522] $65 161%
Reflect Health Contracted [320492] $67 166%
First Health Contracted [320128] $100 247%
Health Alliance Contracted [320164] $102 252%
Aither Health Contracted [320449] $107 265%
Edison Health Solutions Contracted [320502] $107 265%
Mercy Benefit Admin [20251] $107 265%
Yuzu Health Contracted [320521] $107 265%
Workers Comp [20426] $118 - $126 292%
Multiplan Contracted [320270] $126 312%
Private Health Care Systems Contracted [320320] $126 312%
Cigna $286 708%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals