CMS Price Transparency Data

Prosthetic fitting and training

Facility: Prisma Health Laurens County Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $41
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Prisma Health Laurens County Hospital is $41. 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 1.01x the Medicare baseline. Located in 22725 Highway 76 East, Clinton, SC.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $41 (101%)
Cash: $78 (193% of Medicare)
Ins. Median: $41 (101% 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
Medicaid / KanCare $18 - $29 45%
UnitedHealthcare $18 - $395 45%
Blue Cross Blue Shield $22 - $83 54%
Bluechoice [810] $27 - $90 67%
First Choice Benefits Mgmt [3074] $27 67%
Medicare (plans) $27 - $42 67%
Prisma Health Seniorcare Pace - Midlands [5400] $27 - $29 67%
Prisma Health Seniorcare Pace-Upstate [5200] $27 - $29 67%
Humana $29 - $40 72%
Tricare $38 94%
Champva [3049] $39 97%
Cigna $39 - $188 97%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $39 97%
Deseret Mutual Ins Co [3066] $39 97%
Generic Skilled Nursing [3196] $39 97%
Hospice Contracted [1500] $39 97%
Hospice Non Contracted [3190] $39 97%
Triwest Healthcare Alliance Vcp [902] $39 97%
Va Community Care Network-Vaccn [903] $39 97%
Veterans Administration [3194] $39 97%
Sc Dept Of Corrections [2998] $40 99%
Scdc-Sc Dept Of Corrections [7232] $40 99%
Aetna $41 - $97 101%
Healthy Conn Prime-First Choice Vip Care [5300] $41 101%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $41 101%
Promise Health Plan Contracted [2401] $41 - $74 101%
Healthy Conn Prime-Molina Healthcare [5330] $42 104%
Orangeburg Senior Helping Center Pace [5401] $47 - $49 116%
Workers Comp [600] $54 134%
Bob Jones Univ-Pai [821] $70 - $74 173%
Ambetter / Centene $71 176%
Meritain Health Contracted [2200] $75 - $97 186%
Planned Administrators [820] $79 - $83 195%
Preferred Administrators Contracted [2839] $82 - $86 203%
Medcost [2940] $87 - $102 215%
Atlantic Packaging Contracted [4833] $88 - $92 218%
Aps Healthcare System [2981] $94 - $98 233%
Multiplan/Phcs Contracted [2950] $104 - $109 257%
Vsp Vision Care [2986] $105 - $111 260%
First Health Contracted [2952] $109 - $114 270%
Furman Int/Allen University Student [2951] $109 - $114 270%
Quiktrip-First Health [3067] $109 - $114 270%
Evernorth Behavioral Contracted [2982] $188 465%
Mvp Health Care [3037] $188 465%
Golden Rule Insurance Company [2991] $395 977%
Oxford Health Plans [2992] $395 977%
Zzumr-Salt Lake City Ut [3169] $395 977%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22725 Highway 76 East, Clinton, SC 29325
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals