CMS Price Transparency Data

Prosthetic fitting and training

Facility: Penn State Health Hampden Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $44
Cash Discount Price: $79
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Penn State Health Hampden Medical Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.09x the Medicare baseline. Located in 2200 Good Hope Road, Enola, PA.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $79 (195%)

Insurance Median: $44 (109%)

Cash: $79 (195% of Medicare)

Ins. Median: $44 (109% 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
[Amerihealth Caritas]	$33 - $39	82%
[Highmark Wholecare]	$33 - $39	82%
[Geisinger]	$35 - $167	87%
[Health Partners Plans]	$36 - $39	89%
[Pa Health & Wellness]	$36 - $40	89%
[Highmark]	$38 - $115	94%
Aetna	$39 - $107	97%
Humana	$39	97%
UnitedHealthcare	$39 - $156	97%
[Cbc]	$39 - $125	97%
[Healthspring]	$39	97%
[Upmc]	$39 - $185	97%
[Point Comfort Underwriters]	$48	119%
[Highmark Choice Blue]	$92	228%
[Highmark Aca]	$96	238%
Cigna	$153	379%
[Preferred Healthcare Systems]	$188	465%
[First Health]	$200	495%
[Multiplan]	$200	495%

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 $79.
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 Penn State Health Hampden Medical 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.