CMS Price Transparency Data

Prosthetic fitting and training

Facility: Johnson County Community Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $48
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Johnson County Community Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.19x the Medicare baseline. Located in 1901 S Shady St, Mountain City, TN.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $32 (79%)
Insurance Median: $48 (119%)
Cash: $32 (79% of Medicare)
Ins. Median: $48 (119% 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 $27 - $137 67%
Aetna $40 - $87 99%
Amerigroup $40 - $65 99%
Humana $40 99%
Managed Medicaire $40 99%
Medicare (plans) $40 99%
Sentara Health $40 - $46 99%
United Mine Workers Of America $40 99%
UnitedHealthcare $40 - $137 99%
Wellcare $40 99%
Molina Healthcare $41 - $51 101%
Cigna $42 - $66 104%
Devoted Health Plan $42 104%
Nhc Advantage $42 104%
Ambetter / Centene $44 109%
Medcost $48 119%
Optima Health $49 121%
First Health Coventry $103 255%
Seven Corners, Inc. $137 339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 S Shady St, Mountain City, TN 37683
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals