CMS Price Transparency Data

Prosthetic fitting and training

Facility: Frisbie Memorial Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $72
Cash Discount Price: $224
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Frisbie Memorial Hospital is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.78x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$224

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $224 (554%)

Insurance Median: $72 (178%)

Cash: $224 (554% of Medicare)

Ins. Median: $72 (178% 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	$18	45%
Well Sense Health Plan	$27	67%
Humana	$40 - $41	99%
Aetna	$41 - $129	101%
United VA Ccn	$41	101%
Martin's Point Health	$41 - $43	101%
Blue Cross Blue Shield	$41 - $90	101%
Evernorth Behavioral Health	$42	104%
United	$42 - $135	104%
Cigna	$42	104%
Harvard Pilgrim	$59 - $91	146%
Maine Community Health	$64 - $108	158%
Ambetter / Centene	$74	183%
Tufts Health Plan	$77 - $128	191%
Evernorth	$179	443%

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 $224.
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 Frisbie Memorial 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.