CMS Price Transparency Data

Prosthetic fitting and training

Facility: OHSU Hospital and Clinics

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $51
Cash Discount Price: $100
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at OHSU Hospital and Clinics is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.26x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $100 (247%)

Insurance Median: $51 (126%)

Cash: $100 (247% of Medicare)

Ins. Median: $51 (126% 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
Community Health Plan Of Washington	$30 - $60	74%
Care Oregon	$35 - $51	87%
Intercommunity Health Network	$35	87%
Kaiser Foundation Hospitals	$35 - $100	87%
Medicare (plans)	$35 - $69	87%
Pacific Source	$35 - $120	87%
Humana	$43 - $46	106%
Trillium	$43	106%
Moda	$45 - $150	111%
Samaritan Health Plan	$46 - $108	114%
UnitedHealthcare	$46 - $74	114%
Aetna	$47 - $120	116%
Health Net Health Plan Of Oregon, Inc.	$50 - $119	124%
Providence Health Plan	$52 - $131	129%
Tuality Health	$100	247%
Coventry First Health	$116	287%
First Choice	$117	290%
Cigna	$141	349%
Blue Cross Blue Shield	$145	359%
Molina Exchange	$154	381%

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 $100.
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 OHSU Hospital and Clinics 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.