CMS Price Transparency Data

Prosthetic fitting and training

Facility: Southern Hills Hospital and Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $78
Cash Discount Price: $333
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Southern Hills Hospital and Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $333. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.93x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$333

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $333 (824%)

Insurance Median: $78 (193%)

Cash: $333 (824% of Medicare)

Ins. Median: $78 (193% 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	$6 - $78	15%
Community Care Health	$30	74%
Molina Healthcare	$30 - $31	74%
Sierra Hpn	$30	74%
Ambetter / Centene	$31 - $76	77%
Caresource	$31	77%
Humana	$39 - $40	97%
Alignment Health Plan	$40	99%
Blue Cross Blue Shield	$40	99%
Health Net	$40	99%
Hometown Health Mcr	$40	99%
Select Health	$40 - $83	99%
Triwest	$40	99%
Caremore	$41	101%
United	$41 - $78	101%
Imperial Nv	$44	109%
Universal Healthcare	$48	119%
Corvel	$62	153%
Olympus Medsave Usa	$66 - $270	163%
Prominence Healthfirst	$92 - $108	228%
Cmn Global	$128 - $151	317%
Evernorth	$152 - $180	376%
Hometown Health Providers	$152 - $180	376%
Nv Health & Welfare Trust	$183 - $216	453%
Multiplan	$192 - $263	475%
First Health	$201 - $288	497%
Medcare International	$229 - $270	567%

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 $333.
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 Southern Hills Hospital and Medical Center 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.