CMS Price Transparency Data

Prosthetic fitting and training

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $43
Cash Discount Price: $147
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Memorial Mission Hospital and Asheville Surgery Ce is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.06x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $147 (364%)

Insurance Median: $43 (106%)

Cash: $147 (364% of Medicare)

Ins. Median: $43 (106% 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
Blue Cross Blue Shield	$27	67%
United	$27 - $87	67%
Amerihealth	$28	69%
Partners Health Management	$28	69%
Vaya Health	$28	69%
Wellcare	$28 - $40	69%
Apex Health	$29	72%
Alignment Health	$39	97%
United Behavioral Health	$39	97%
Aetna	$40 - $106	99%
Humana	$40	99%
Provider Partners Health Plan	$41	101%
Pruitthealth Premier	$41	101%
Cigna	$42 - $73	104%
Troy Healthcare	$42	104%
Healthteam Advantage	$43	106%
Amerihealth Caritas	$44 - $69	109%
Longevity Health Plan	$46	114%
Oscar	$52	129%
Caresource	$65	161%
Medcost	$83 - $125	205%
Magellan	$88	218%
Magellan Behavioral Health	$88	218%
Multiplan	$118	292%
Avalon Administrative Services	$125	309%
Prime Health	$129 - $132	319%

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 $147.
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 Memorial Mission Hospital and Asheville Surgery Ce 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.