CMS Price Transparency Data

Prosthetic fitting and training

Facility: John Randolph Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $44
  • Cash Discount Price: $367
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at John Randolph Medical Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $367. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.09x the Medicare baseline. Located in 411 West Randolph Road, Hopewell, VA.
Cash / Self-Pay
$367

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $367 (908%)
Insurance Median: $44 (109%)
Cash: $367 (908% of Medicare)
Ins. Median: $44 (109% 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
Triatlantic $34 84%
Health Net $38 94%
Humana $39 - $41 97%
Johns Hopkins $40 99%
Aetna $41 - $121 101%
Devoted $41 101%
Sentara Health $41 101%
United $41 - $165 101%
United Behavioral Health $41 101%
Blue Cross Blue Shield $42 104%
Virginia Premier Health $42 104%
Cigna $43 106%
Clear Spring Health Plan $43 106%
Davita Village Health $43 106%
Evernorth Behavioral Health $43 106%
Align Senior Care $44 109%
Pyramid Life $44 109%
Naphcare $55 136%
Oscar $62 153%
Lifeworks $70 173%
Universal Healthcare Group $81 200%
Virginia Health Network $128 - $239 317%
Value Options $220 544%
Corvel $264 653%
Occunet Workers Comp $294 728%
4Most Health Nework $330 817%
Multiplan $330 817%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 411 West Randolph Road, Hopewell, VA 23860
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals