CMS Price Transparency Data

Prosthetic fitting and training

Facility: Missouri Baptist Sullivan Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $66
Cash Discount Price: $58
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Missouri Baptist Sullivan Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.63x the Medicare baseline. Located in 751 Sappington Bridge Rd, Sullivan, MO.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $58 (144%)

Insurance Median: $66 (163%)

Cash: $58 (144% of Medicare)

Ins. Median: $66 (163% 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
Aetna	$21 - $72	52%
Essence Healthcare [221]	$21	52%
Humana	$21 - $64	52%
Blue Cross Blue Shield	$22 - $216	54%
Cox Health [757]	$22	54%
UnitedHealthcare	$22 - $71	54%
Devoted Health Plan [847]	$23	57%
Medica [662]	$23	57%
Healthlink [225]	$47 - $72	116%
Cox Health Systems Insurance Company [220]	$53 - $62	131%
Health Alliance [224]	$53	131%
Allied Benefits [498]	$56 - $71	139%
Hope Trust [806]	$56	139%
Cigna	$58 - $77	144%
Coresource [497]	$58	144%
Fmh Benefit Service Inc [222]	$58	144%
Mail Handlers [495]	$58	144%
Healthscope Benefits [258]	$62 - $65	153%
Med-Pay [480]	$62 - $72	153%
Unicare [568]	$62 - $72	153%
Apwu Health Plan [216]	$66	163%
Nalc Health Benefit Plan [242]	$66	163%
Priority Health [648]	$66	163%
First Health Commercial [734]	$71	176%
Beechstreet [551]	$72	178%
Detego Health [868]	$72	178%
Health Systems Inc [620]	$72	178%
Healthcare Sol Mercy [609]	$72	178%
Multiplan Commercial [737]	$72	178%
Multiplan [240]	$72	178%
Phcs [244]	$72 - $77	178%
Preferred Health Professionals [561]	$72	178%
Hfn [563]	$77	191%
Medica [661]	$77	191%
Consociate [478]	$237	586%
Sarah Bush Lincoln [636]	$237	586%

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 $58.
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 Missouri Baptist Sullivan Hospital 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.