CMS Price Transparency Data

Prosthetic fitting and training

Facility: Carolinas Rehabilitation

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $40
Cash Discount Price: $40
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Carolinas Rehabilitation is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.99x the Medicare baseline. Located in 1100 Blythe Blvd, Charlotte, NC.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $40 (99%)

Insurance Median: $40 (99%)

Cash: $40 (99% of Medicare)

Ins. Median: $40 (99% 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
Amerihealth Caritas	$23 - $31	57%
Carolina Complete Health	$23 - $32	57%
Healthy Blue	$23 - $32	57%
UnitedHealthcare	$23 - $53	57%
Wellcare	$23 - $32	57%
Ambetter / Centene	$25 - $30	62%
Blue Cross Blue Shield	$28 - $39	69%
Cigna	$35 - $55	87%
Employers Health Network	$36	89%
Aetna	$38 - $69	94%
Humana	$39	97%
Physician Reach Out	$40	99%
Medcost	$47 - $54	116%
Quik Trip	$52	129%
Choicecare	$63	156%
Healthgram	$65	161%
Private Health Care Systems	$66	163%
First Health	$69	171%
Beechstreet	$74	183%
Multiplan	$74	183%

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 $40.
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 Carolinas Rehabilitation 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.