CMS Price Transparency Data

Prosthetic fitting and training

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $94
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 2.33x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Intermountain Health Sanpete Valley Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.33x the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $78 (193%)
Insurance Median: $94 (233%)
Cash: $78 (193% of Medicare)
Ins. Median: $94 (233% 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 233% of the Medicare baseline (a markup of 133%). 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.

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
Health Plan Of Nevada $27 - $97 67%
Molina $27 - $104 67%
Selecthealth $27 - $104 67%
Aetna $30 - $105 74%
American Health $30 - $40 74%
Blue Cross Blue Shield $30 - $104 74%
Health Partners Of Nevada $30 - $40 74%
Healthy U $30 - $97 74%
Humana $30 - $104 74%
UnitedHealthcare $30 - $104 74%
Triwest $31 - $99 77%
Injury Care Of Nevada $74 - $82 183%
Byu Risk Management $84 - $93 208%
Corporation Of The President $84 - $93 208%
Corvel Corporation $84 - $93 208%
Wcf Insurance $84 - $93 208%
Awh Connected $94 - $105 233%
Byu Athletics $94 - $104 233%
Campbell Scientific $94 - $104 233%
Cigna $94 - $104 233%
Deseret Mutual $94 - $104 233%
Emi $94 - $104 233%
Emi Health $94 - $104 233%
Franklin County $94 - $104 233%
Global Excel $94 - $104 233%
Health Utah $94 - $104 233%
Hygeia Corporation $94 - $104 233%
Ifit $94 - $104 233%
Juniper Systems $94 - $104 233%
Lw Miller $94 - $104 233%
Managed Care Admin $94 - $104 233%
Medcare International $94 - $104 233%
Motivhealth $94 - $104 233%
Pehp $94 - $104 233%
Prodegi Corp Benefit $94 - $104 233%
Springtide $94 - $104 233%
Tanner Llc $94 - $104 233%
Uofu $94 - $104 233%
Utah Tech $94 - $104 233%
Wise Network $94 - $104 233%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 South Medical Drive, Mount Pleasant, UT 84647
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals