CMS Price Transparency Data

Prosthetic fitting and training

Facility: Wooster Community Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $74
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Wooster Community Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.83x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $95 (235%)
Insurance Median: $74 (183%)
Cash: $95 (235% of Medicare)
Ins. Median: $74 (183% 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
Aultcare/Primecare Mcr Adv $38 - $55 94%
Blue Cross Blue Shield $38 - $103 94%
Buckeye Mcare $38 94%
Caresource Mcr Adv $38 94%
Humana $38 - $106 94%
Med Mutual Of Oh Mcr $38 94%
Molina Mcr $38 94%
Summacare Mcr $38 94%
The Health Plan Mcr Adv $38 94%
Tricare $38 94%
UnitedHealthcare $38 - $107 94%
Valor Hp Mcr-All Plans $38 94%
Magnipower-All Plans $50 124%
Cerco-All Plans $54 - $79 134%
Caresource Exch - All Other Plans $55 136%
Aetna $58 - $112 144%
Aultcare Wayne County $58 - $84 144%
Aultcare/Primetime Exch $58 - $84 144%
Rayco-All Plans $58 - $84 144%
Christian Health Ministries-All Plans $62 - $90 153%
Cigna $62 - $90 153%
Health Ohio Network Employer $62 - $90 153%
Wayne County-All Plans $62 - $90 153%
Healthsmart Accel $64 - $93 158%
Summacare Preferred Choice $64 - $93 158%
Health Ohio Network Ppo-All Other Plans $65 - $96 161%
Healthsmart Complete Ppo-All Other Plans $65 - $96 161%
Molina Marketplace - All Other Plans $65 161%
Ohio Health Choice Supp $65 - $96 161%
Ohio Health Group Hlthy - All Other Plans $65 - $96 161%
Med Mutual Of Oh Exchange $66 - $97 163%
Med Mutual Of Oh Supermed $66 - $97 163%
Med Mutual Of Oh Trad-All Other Plans $66 - $97 163%
Health Plan Of Upper Ohio-All Plans $68 - $99 168%
Ohio Health Group Pref $68 - $100 168%
The Health Plan Comm - All Other Plans $68 - $99 168%
Aultcare/Primetime-All Other Plans $69 - $101 171%
Healthsmart Ppo $70 - $102 173%
Ohio Health Choice-All Other Plans $72 - $106 178%
Summacare-All Other Plans $72 - $105 178%
Healthsmart Hpo $73 - $107 181%
Osu-All Plans $73 - $107 181%
Buckeye Mcaid-All Other Plans $74 183%
Caresource Mcaid $74 183%
Central Benefits-All Plans $74 - $108 183%
First Health-All Plans $74 - $108 183%
Flora-All Plans $74 - $108 183%
Beech Street-All Plans $75 - $109 186%
Clarity Health - All Plans $75 186%
Phcs-All Plans $75 - $109 186%
Molina Mcaid $76 188%
Amerihealth Mcaid-All Plans $78 193%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals