CMS Price Transparency Data

Prosthetic fitting and training

Facility: University Hospitals - Elyria Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $89
  • Cash Discount Price: $134
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at University Hospitals - Elyria Medical Center is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.20x the Medicare baseline. Located in 630 East River Street, Elyria, OH.
Cash / Self-Pay
$134

Average discount available for prompt cash payment at this facility.

Insurance Median
$89

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: $134 (332%)
Insurance Median: $89 (220%)
Cash: $134 (332% of Medicare)
Ins. Median: $89 (220% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 220% of the Medicare baseline (a markup of 120%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $38 - $121 94%
Blue Cross Blue Shield $38 - $82 94%
Cigna $38 - $187 94%
Devoted Health $38 94%
Humana $38 94%
Medical Mutual Of Ohio $38 - $87 94%
Molina $38 94%
Primetime Health Plan $38 94%
Summacare $38 - $91 94%
The Health Plan $38 - $117 94%
UnitedHealthcare $38 - $108 94%
Wellcare By Allwell $38 94%
Paramount $39 97%
Perennial Advantage Of Ohio $40 99%
Valor Health Plans $40 99%
Ambetter / Centene $69 171%
Caresource $69 171%
University Health Employee Plan (Contigo) $71 176%
Amish Aid Community Plan $82 - $85 203%
Amish Church Fund And Workers Aid Plan $82 - $85 203%
Buckeye Plain Ministries $82 - $85 203%
Jp Farley $84 208%
Clarity $85 210%
Christian Healthcare Ministries $89 220%
Immergrun $89 220%
Sunrise Plan Communities $89 220%
Aultcare $98 243%
Healthsmart $116 287%
Ohio Health Choice $116 - $160 287%
Medical Mutual Traditional/Health Ohio $125 309%
Beech Street $142 - $160 351%
Ohio Preferred Network $142 - $160 351%
First Health $148 366%
Century Health Network $151 374%
Private Healthcare System $153 379%
Configurenet $160 396%
Fortified Provider Network $160 396%
Multiplan $160 396%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 630 East River Street, Elyria, OH 44035
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals