CMS Price Transparency Data

Prosthetic fitting and training

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $41
Cash Discount Price: $119
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at The University of Vermont Health Network-Alice Hy is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.01x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $119 (294%)

Insurance Median: $41 (101%)

Cash: $119 (294% of Medicare)

Ins. Median: $41 (101% 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
Blue Cross Blue Shield	$33 - $98	82%
Aetna	$38 - $102	94%
Capital District Physicians' Health Plan	$38 - $112	94%
Choicecare	$38 - $89	94%
Fidelis Care	$38 - $92	94%
Humana	$38	94%
Martins Point	$38	94%
Mvp	$38 - $99	94%
St. Regis	$38	94%
UnitedHealthcare	$38 - $484	94%
Veterans Affairs Community Care Network	$38	94%
Magnacare	$95	235%
Highmark Blueshield	$107	265%

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 $119.
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 The University of Vermont Health Network-Alice Hy 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.