CMS Price Transparency Data

Prosthetic fitting and training

Facility: Lafayette Regional Health Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $110
  • Cash Discount Price: $255
  • vs. Medicare Baseline: 2.72x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Lafayette Regional Health Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.72x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$255

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $255 (631%)
Insurance Median: $110 (272%)
Cash: $255 (631% of Medicare)
Ins. Median: $110 (272% 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 272% of the Medicare baseline (a markup of 172%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
United $20 - $115 49%
Aetna $21 - $223 52%
Amerigroup $21 52%
Healthyblue $21 52%
Home State Health Plan $21 52%
Medicaid / KanCare $21 52%
Unicare $21 52%
Ambetter / Centene $47 116%
Nhc Advantage $48 119%
Corvel Corporation $53 - $216 131%
Oha Network $54 - $127 134%
Universal Healthcare $66 163%
Humana $86 - $110 213%
Blue Cross Blue Shield $97 - $255 240%
College Park Family Care Center $110 272%
Oscar $127 314%
Cigna $145 - $182 359%
Wppa Providrs Care Network $191 473%
Multiplan $199 492%
Coventry $203 502%
Coventry Kc Mo $203 502%
Cco, Inc. $216 535%
Focus Healthcare Mgmt, Inc $229 567%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals