CMS Price Transparency Data

Prosthetic fitting and training

Facility: Inspira Medical Center Vineland

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $43
Cash Discount Price: $144
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Inspira Medical Center Vineland is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.06x the Medicare baseline. Located in 1505 W Sherman Ave, Vineland, NJ.

Cash / Self-Pay

$144

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: $144 (356%)

Insurance Median: $43 (106%)

Cash: $144 (356% 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
UnitedHealthcare	$25 - $563	62%
Aetna	$27 - $101	67%
Fidelis Care Of Nj	$27	67%
Wellpoint	$28	69%
Amerihealth	$40	99%
Blue Cross Blue Shield	$40 - $63	99%
Braven Health	$43	106%
Clover Health	$43	106%
Horizon Nj Total Care	$43	106%
Medicare (plans)	$43	106%
Wellcare Dual Liberty	$43	106%
Wellpoint Full Dual Advantage	$43	106%
Healthspring	$45	111%
Humana	$45	111%
Jefferson Health Plan	$46	114%
Cigna	$59	146%
Horizon Nj Health	$60	148%
Ambetter / Centene	$89	220%
Oxford Health Plans	$563	1393%

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 $144.
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 Inspira Medical Center Vineland 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.