CMS Price Transparency Data

Prosthetic fitting and training

Facility: Baptist Memorial Hospital - Carroll County

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $105
Cash Discount Price: $37
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Baptist Memorial Hospital - Carroll County is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.60x the Medicare baseline. Located in 631 Rb Wilson Dr, Huntingdon, TN.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $37 (92%)

Insurance Median: $105 (260%)

Cash: $37 (92% of Medicare)

Ins. Median: $105 (260% 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 260% of the Medicare baseline (a markup of 160%). 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
Blue Cross Blue Shield	$23 - $95	57%
Aetna	$27 - $99	67%
Magnolia Tn	$35	87%
Ppo Holdings	$60	148%
Magnolia Regional Health Center	$64	158%
Littler	$80	198%
UnitedHealthcare	$92	228%
Humana	$105	260%
First Choice Health Plan Of Ms	$111	275%
Oscar	$117	290%
Mpcn	$119	294%
Multiplan	$119	294%
Novasys	$119	294%
Ppo Plus	$135	334%
Qca	$143	354%
Cigna	$148 - $204	366%

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 $37.
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 Baptist Memorial Hospital - Carroll County 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.