CMS Price Transparency Data

Prosthetic fitting and training

Facility: Intermountain Health Heber Valley Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $87
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 2.15x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Intermountain Health Heber Valley Hospital is $87. 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 2.15x the Medicare baseline. Located in 454 East Medical Way, Heber City, UT.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $87 (215%)
Cash: $78 (193% of Medicare)
Ins. Median: $87 (215% 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 215% of the Medicare baseline (a markup of 115%). 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
Aetna $30 - $97 74%
American Health $30 - $33 74%
Blue Cross Blue Shield $30 - $97 74%
Health Partners Of Nevada $30 - $33 74%
Health Plan Of Nevada $30 - $98 74%
Healthy U $30 - $98 74%
Humana $30 - $33 74%
Molina $30 - $98 74%
Selecthealth $30 - $98 74%
UnitedHealthcare $30 - $97 74%
Triwest $33 - $83 82%
Corporation Of The President $74 - $82 183%
Corvel Corporation $74 - $82 183%
Injury Care Of Nevada $74 - $82 183%
Wcf Insurance $74 - $82 183%
Byu Risk Management $84 - $93 208%
Cigna $84 - $97 208%
Medcare International $84 - $93 208%
Springtide $84 - $93 208%
Uofu $84 - $93 208%
Byu Athletics $86 - $95 213%
Campbell Scientific $86 - $95 213%
Emi Health $86 - $95 213%
Franklin County $86 - $95 213%
Ifit $86 - $95 213%
Juniper Systems $86 - $95 213%
Lw Miller $86 - $95 213%
Managed Care Admin $86 - $95 213%
Motivhealth $86 - $95 213%
Prodegi Corp Benefit $86 - $95 213%
Tanner Llc $86 - $95 213%
Utah Tech $86 - $95 213%
Wise Network $86 - $95 213%
Awh Connected $87 - $98 215%
Deseret Mutual $87 - $97 215%
Emi $87 - $97 215%
Intermountain Caregiver Plan $87 - $97 215%
Pehp $87 - $99 215%
Global Excel $89 - $99 220%
Health Utah $89 - $99 220%
Hygeia Corporation $89 - $99 220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 East Medical Way, Heber City, UT 84032
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals