CMS Price Transparency Data
Prosthetic fitting and training
Facility: Mercy Hospital Watonga, Inc
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $67
- Cash Discount Price: $78
- vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Mercy Hospital Watonga, Inc is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.66x the Medicare baseline. Located in 500 North Clarence Nash Boulevard, Watonga, OK.
Cash / Self-Pay
$78
Average discount available for prompt cash payment at this facility.
Insurance Median
$67
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: $78 (193%)
Insurance Median: $67 (166%)
Cash: $78 (193% of Medicare)
Ins. Median: $67 (166% 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 |
|---|---|---|
| Aetna | $36 - $91 | 89% |
| Ambetter / Centene | $36 | 89% |
| Home State Health Plan Contracted [320187] | $36 | 89% |
| Humana | $36 - $46 | 89% |
| Medicaid / KanCare | $36 | 89% |
| Novasys Contracted [320285] | $36 | 89% |
| Blue Cross Blue Shield | $46 - $62 | 114% |
| Cherokee Nation Health Serv Contracted [320066] | $46 | 114% |
| Cross Timbers Hospice [20098] | $46 | 114% |
| Dept Of Veteran Affairs Contracted [320106] | $46 | 114% |
| Elara Caring Aspire Hospice Contracted [320433] | $46 | 114% |
| Elara Caring Aspire Hospice [20433] | $46 | 114% |
| Halo Hcr Inc Hospice Contracted [320432] | $46 | 114% |
| Halo Hcr Inc Hospice [20432] | $46 | 114% |
| Independent Health [20197] | $46 | 114% |
| Indian Health Service Contracted [320198] | $46 | 114% |
| Kindful Hospice Contracted [320434] | $46 | 114% |
| Kindful Hospice [20434] | $46 | 114% |
| Medical Associates Health [20444] | $46 | 114% |
| Medicare (plans) | $46 - $67 | 114% |
| Mercy Hospice Okc [20252] | $46 | 114% |
| Provider Partners Health Plans Contracted [320450] | $46 | 114% |
| Qual Choice Contracted [320325] | $46 | 114% |
| Tribute Health Plan Mcr Contracted [320338] | $46 | 114% |
| Tricare | $46 | 114% |
| UnitedHealthcare | $46 - $95 | 114% |
| Cigna | $47 - $102 | 116% |
| Globalhealth Contracted [320145] | $47 | 116% |
| Webtpa Contracted [320417] | $50 | 124% |
| Health Choice Contracted [320166] | $63 | 156% |
| Medica Contracted [320239] | $67 | 166% |
| Aither Health Contracted [320449] | $72 - $102 | 178% |
| Mercy Benefit Admin Contracted [320251] | $72 - $102 | 178% |
| Quik Trip Contracted [320447] | $72 | 178% |
| Show-Me Health Administrators Contracted [320483] | $72 | 178% |
| Benefit Management Contracted [320052] | $78 - $90 | 193% |
| Healthsmart Accel Contracted [320183] | $84 | 208% |
| Osma Health Contracted [320292] | $84 | 208% |
| Healthcare Highways Plus Contracted [320175] | $90 | 223% |
| Preferred Community Choice Contracted [320311] | $90 | 223% |
| Private Health Care Systems Contracted [320320] | $90 - $96 | 223% |
| United Medical Resources Contracted [320454] | $95 | 235% |
| Multiplan Contracted [320270] | $96 - $108 | 238% |
| First Health Contracted [320128] | $97 | 240% |
| Auxiant Contracted [320462] | $102 | 252% |
| Ebms Contracted [320493] | $102 | 252% |
| Healthlink Contracted [320179] | $102 | 252% |
| Healthsmart Preferred Care Contracted [320184] | $102 | 252% |
| Imagine 360 Contracted [320494] | $102 | 252% |
| Reflect Health Contracted [320492] | $102 | 252% |
| Yuzu Health Contracted [320521] | $102 | 252% |