CMS Price Transparency Data

Prosthetic fitting and training

Facility: Valley Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $121
Cash Discount Price: $108
vs. Medicare Baseline: 2.99x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Valley Medical Center is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.99x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $108 (267%)

Insurance Median: $121 (299%)

Cash: $108 (267% of Medicare)

Ins. Median: $121 (299% 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 299% of the Medicare baseline (a markup of 199%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$46 - $121	114%
Regence Blue Shield [170100]	$59 - $62	146%
Regence Uniform [130111]	$59	146%
Blue Cross Blue Shield	$62	153%
Regence Hma [170105]	$62	153%
Regence Hma1 [170102]	$62	153%
Bh United [180100]	$65	161%
Benefit Md [150113]	$121	299%
Carpenters Trust [150122]	$121	299%
Cement Masons And Plasterers [150127]	$121	299%
Coresource [150109]	$121	299%
Employee Benefit Management Services [150108]	$121	299%
Fc Moda Health [150139]	$121	299%
First Choice Health Administrators [150110]	$121	299%
First Choice Health Comp [150112]	$121	299%
First Choice [150134]	$121	299%
Health Net [150111]	$121	299%
Here [150114]	$121	299%
Hotel Employees Health Trust [150115]	$121	299%
International Longshore & Warehouse Union [150116]	$121	299%
Kitsap Physician Services [150118]	$121	299%
Loomis Benefits West [150119]	$121	299%
Mega [150120]	$121	299%
Midwest [150121]	$121	299%
Nw Administrators [150123]	$121	299%
Operating Engineers [150125]	$121	299%
Painters Trust [150126]	$121	299%
Puget Sound Electric [150131]	$121	299%
Seattle Plumb And Pipe [150132]	$121	299%
Trusteed Plan [150101]	$121	299%
United Employee Benefit Trust [150137]	$121	299%
Washington Bakers Trust [150102]	$121	299%
Washington Employers Trust [150103]	$121	299%
Washington State Health Ins Pool [150104]	$121	299%
Welfare Pension Administration Services [150105]	$121	299%
Zenith Admin [150106]	$121	299%
Zzjohn Alden [150117]	$121	299%
Zzprincipal Financial Group [150128]	$121	299%
Zzprovidence [150129]	$121	299%

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 $108.
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 Valley Medical Center 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.