CMS Price Transparency Data

Prosthetic fitting and training

Facility: Mercy Hospital Marietta

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $76
Cash Discount Price: $127
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Mercy Hospital Marietta is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.88x the Medicare baseline. Located in 300 Wanda Street, Marietta, OK.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $127 (314%)

Insurance Median: $76 (188%)

Cash: $127 (314% of Medicare)

Ins. Median: $76 (188% 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
Aetna	$36 - $89	89%
Humana	$36 - $41	89%
Medicaid / KanCare	$36	89%
Blue Cross Blue Shield	$41 - $62	101%
Cross Timbers Hospice [20098]	$41	101%
Elara Caring Aspire Hospice Contracted [320433]	$41	101%
Elara Caring Aspire Hospice [20433]	$41	101%
Halo Hcr Inc Hospice Contracted [320432]	$41	101%
Halo Hcr Inc Hospice [20432]	$41	101%
Independent Health [20197]	$41	101%
Indian Health Service Contracted [320198]	$41	101%
Kindful Hospice Contracted [320434]	$41	101%
Kindful Hospice [20434]	$41	101%
Medical Associates Health [20444]	$41	101%
Medicare (plans)	$41 - $43	101%
Mercy Hospice Okc [20252]	$41	101%
Tricare	$43	106%
UnitedHealthcare	$43 - $89	106%
Cigna	$45 - $95	111%
Webtpa Contracted [320417]	$53	131%
Aither Health Contracted [320449]	$76 - $108	188%
Mercy Benefit Admin Contracted [320251]	$76 - $114	188%
Quik Trip Contracted [320447]	$76	188%
Show-Me Health Administrators Contracted [320483]	$76	188%
Osma Health Contracted [320292]	$89	220%
United Medical Resources Contracted [320454]	$89 - $114	220%
First Health Contracted [320128]	$90	223%
Benefit Management Contracted [320052]	$95 - $114	235%
Healthcare Highways Plus Contracted [320175]	$95	235%
Auxiant Contracted [320462]	$108 - $114	267%
Ebms Contracted [320493]	$108	267%
Healthlink Contracted [320179]	$108 - $114	267%
Preferred Community Choice Contracted [320311]	$108	267%
Federal Medical Center Contracted [320127]	$114	282%
Healthscope Contracted [320182]	$114	282%
Point C Contracted [320238]	$114	282%
Preferred Health Plan Contracted [320522]	$114	282%
Tri State Healthcare Coalition Contracted [320379]	$114	282%

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 $127.
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 Mercy Hospital Marietta 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.