CMS Price Transparency Data

Prosthetic fitting and training

Facility: Island Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $32
Cash Discount Price: $81
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Island Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.79x the Medicare baseline. Located in 1211 24Th Street, Anacortes, WA.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $81 (200%)

Insurance Median: $32 (79%)

Cash: $81 (200% of Medicare)

Ins. Median: $32 (79% 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
Molina Mcaid - All Plans	$26 - $28	64%
Amerigroup Mcaid - All Plans	$27 - $30	67%
Aarp Mcr Adv - All Plans	$29	72%
Humana	$29 - $69	72%
Kaiser Mcr Adv	$29	72%
Samish Indian Health - All Plans	$29	72%
Swinomish Indian Health - All Plans	$29	72%
Tricare	$29	72%
UnitedHealthcare	$29 - $69	72%
Coordinated Care Mcaid - All Plans	$30 - $33	74%
Aetna	$31 - $77	77%
Chpw Mcaid - All Plans	$31	77%
Premera Mcr Adv	$31	77%
Premera Comm - All Other Plans	$54	134%
Regence Comm - All Other Plans	$61	151%
Cigna	$65	161%
First Choice - All Plans	$69	171%
First Health - All Plans	$69	171%
Multiplan - All Plans	$69	171%

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 $81.
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 Island Hospital 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.