Prosthetic fitting and training
Facility: Yoakum Community Hospital
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $122
- Cash Discount Price: $104
- vs. Medicare Baseline: 3.02x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 302% of the Medicare baseline (a markup of 202%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $66 - $153 | 163% |
| Humana | $66 | 163% |
| Medicare (plans) | $66 | 163% |
| Prime Health Svcs Mcr Advantage | $66 | 163% |
| Scott & White Mcare Advan | $66 | 163% |
| Superior Mcr Advantage | $66 | 163% |
| Triwest Va Ccn-All Plans | $66 | 163% |
| Tx Independent Hp Mcr Advantage-All Plans | $66 | 163% |
| UnitedHealthcare | $66 - $128 | 163% |
| Superior Hix-All Other Plans | $82 | 203% |
| Kempton Group Admin Ppo-All Plans | $105 | 260% |
| Entrust - All Plans | $112 | 277% |
| Medicaid / KanCare | $116 - $160 | 287% |
| Amera-Net-All Plans | $120 | 297% |
| Scott & White Ppo-All Other Plans | $120 | 297% |
| Healthsmart Ppo-All Other Plans | $125 | 309% |
| Blue Bell Creameries Emp-All Plans | $128 | 317% |
| Cigna | $128 | 317% |
| Americas Health Plan-All Plans | $136 | 337% |
| Beech Street-All Plans | $136 | 337% |
| Directcare America-All Plans | $136 | 337% |
| Galaxy Ppo - All Plans | $136 | 337% |
| Health Star Comm Ip/Op Only - All Plans | $136 | 337% |
| Medcorp Southwest Ppo-All Plans | $136 | 337% |
| Medical Control Ppo-All Plans | $136 | 337% |
| Phcs Multiplan - All Plans | $136 | 337% |
| Aetna | $144 | 356% |
| Healthsmart Work Comp | $144 | 356% |
| Prime Health Svcs Ppo-All Other Plans | $144 | 356% |