CMS Price Transparency Data

Prosthetic fitting and training

Facility: University Health System, Inc

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $50
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at University Health System, Inc is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.24x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $28 (69%)
Insurance Median: $50 (124%)
Cash: $28 (69% of Medicare)
Ins. Median: $50 (124% 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
Blue Cross Blue Shield $30 - $126 74%
UnitedHealthcare $30 - $78 74%
Cigna $38 - $85 94%
Humana $38 94%
Aetna $39 - $78 97%
Devoted Health $39 97%
American Health $40 99%
Medicare (plans) $40 99%
Nhc $40 99%
Wellcare-Windsor Medadv $40 99%
Wellpoint $40 - $41 99%
Fentress County Sheriffs Dept $45 111%
Multiplan $67 166%
Nx Health $67 166%
Phcs $67 166%
Naphcare $72 178%
Coventry $78 193%
Beechstreet $84 208%
Prime Health $84 - $112 208%
Seven Corners $84 208%
Usa $89 220%
Evolutions $100 247%
Galaxy $100 247%
Healthsmart $100 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1924 Alcoa Highway, Knoxville, TN 37920
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals