CMS Price Transparency Data

Prosthetic fitting and training

Facility: Montefiore Mount Vernon Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $77
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.91x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Montefiore Mount Vernon Hospital is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.91x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$77

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%)
Insurance Median: $77 (191%)
Ins. Median: $77 (191% 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.

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
American Postal Workers $43 106%
UnitedHealthcare $43 - $77 106%
Healthfirst $45 - $125 111%
Metroplus $46 - $138 114%
Blue Cross Blue Shield $47 - $173 116%
Emblem $47 - $284 116%
Fidelis $47 - $134 116%
Point Comfort $47 116%
Villagecaremax $47 116%
Vnsny Choice $47 - $88 116%
Wellcare $48 - $78 119%
Humana $51 126%
Longevity $51 126%
Molina Healthcare Of Ny Affinity $64 - $173 158%
Amidacare $77 191%
Medicaid / KanCare $77 191%
Mvp $77 - $176 191%
Hamaspik $81 - $83 200%
Vnsny Select Health $88 218%
Cigna $284 - $315 703%
Northwell $394 975%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals