CMS Price Transparency Data

Prosthetic fitting and training

Facility: Southern Coos Hospital & Health Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $84
Cash Discount Price: $97
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Southern Coos Hospital & Health Center is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.08x the Medicare baseline. Located in 900 11Th Street Se, Bandon, OR.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$84

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: $97 (240%)

Insurance Median: $84 (208%)

Cash: $97 (240% of Medicare)

Ins. Median: $84 (208% 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 208% of the Medicare baseline (a markup of 108%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tricare	$54 - $58	134%
Advanced Health - All Plans	$59 - $63	146%
Aetna	$62 - $90	153%
Atrio Mcr Adv - Allplans	$62 - $66	153%
Confederated Tribes - All Plans	$62 - $66	153%
Moda Mcr Adv	$62 - $66	153%
Pacific Source Mcr Adv	$62 - $66	153%
Cigna	$74 - $79	183%
Healthnet - All Plans	$78 - $83	193%
Moda Health Plan - All Other Plans	$83 - $89	205%
Prov Netwrk Of America - All Plans	$84 - $90	208%
Three Rivers - All Plans	$84 - $90	208%
UnitedHealthcare	$84 - $90	208%
First Choice - All Plans	$86 - $92	213%
Blue Cross Blue Shield	$87 - $93	215%
Multiplan - All Plans	$87 - $93	215%
First Health - All Plans	$89 - $95	220%
Pacific Source - All Other Plans	$89 - $95	220%
Providence Preferred - All Plans	$89 - $95	220%

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 $97.
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 Southern Coos Hospital & Health Center 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.