CMS Price Transparency Data

Prosthetic fitting and training

Facility: Holy Cross Hospital - Salt Lake

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $73
Cash Discount Price: $55
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Holy Cross Hospital - Salt Lake is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.81x the Medicare baseline. Located in 1050 East South Temple, Salt Lake City, UT.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $55 (136%)

Insurance Median: $73 (181%)

Cash: $55 (136% of Medicare)

Ins. Median: $73 (181% 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.

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	$37 - $83	92%
Denver Health	$42	104%
Health Choice	$42	104%
Humana	$42	104%
Medicaid / KanCare	$42	104%
Medicare (plans)	$42	104%
Rocky Mountain Health Plan	$42	104%
Uuhp	$42 - $75	104%
Employer Direct Healthcare	$51	126%
Motivhealth	$54	134%
Molina	$59 - $87	146%
Pehp	$59 - $164	146%
Aetna	$61 - $117	151%
Centura Employee Plan	$72	178%
Wise	$72 - $73	178%
Deseret Mutual Benefit Administrators	$85	210%
Select Health	$91	225%
Multiplan	$95 - $125	235%
Cigna	$110 - $302	272%
Emi Health	$138	341%
UnitedHealthcare	$316	782%

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 $55.
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 Holy Cross Hospital - Salt Lake 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.