CMS Price Transparency Data

Prosthetic fitting and training

Facility: Lafollette Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $39
  • Cash Discount Price: $48
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Lafollette Medical Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.97x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$48

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $48 (119%)
Insurance Median: $39 (97%)
Cash: $48 (119% of Medicare)
Ins. Median: $39 (97% 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 $25 - $142 62%
Bluecare $25 - $29 62%
Amerigroup $34 84%
Humana $35 - $38 87%
Tricare $36 89%
Triwest $37 92%
Medicare (plans) $38 94%
Node Bluecare Plus Tn Mcr Adv $38 94%
Node Champva $38 94%
Node Devoted Health Mcr Adv $38 94%
Node Farm Bureau Mcr Adv $38 94%
Node Hospice Non Par Agree $38 94%
Node Va $38 94%
Node Wellcare Mcr Adv $38 94%
UnitedHealthcare $38 - $306 94%
Veterans Eval Services $38 94%
Aetna $39 - $100 97%
Node Amerigroup Mcr Adv $39 97%
Node Blueadvantage Mcr Adv $39 97%
Node Healthspring Mcr Adv $39 97%
Windsor Health Plan $39 97%
Medicaid / KanCare $40 - $48 99%
Wellcare $40 99%
Node Nhc Mcr Adv $41 101%
Self Pay $46 114%
Novanet Work Comp Tn $56 139%
Tn Work Comp $57 141%
Node Us Dept Of Labor $60 148%
Ambetter / Centene $71 176%
Node Point Comfort Underwriters $84 208%
Multiplan Complementary $123 304%
Cigna $134 332%
Beech Street Work Comp Tn $5,663 14014%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals