CMS Price Transparency Data

Prosthetic fitting and training

Facility: Snoqualmie Valley Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $81
Cash Discount Price: $104
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Snoqualmie Valley Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.00x the Medicare baseline. Located in 9801 Frontier Ave Se, Snoqualmie, WA.

Cash / Self-Pay

$104

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $104 (257%)

Insurance Median: $81 (200%)

Cash: $104 (257% of Medicare)

Ins. Median: $81 (200% 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 200% of the Medicare baseline (a markup of 100%). 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
Aetna	$73 - $106	181%
Amerigroup Wellpoint	$73 - $90	181%
Community Health Plan Of Wa	$73 - $79	181%
Medicare (plans)	$73 - $77	181%
Molina Healthcare Of Washington Mcr Adv	$73 - $77	181%
Blue Shield Of Wa Regence Mcr Adv	$74 - $78	183%
Humana	$74 - $78	183%
Molina Healthcare Of Washington	$75 - $79	186%
UnitedHealthcare	$75 - $168	186%
Washington Coordinated Care	$75 - $92	186%
Community Health Plan Of Wa Mcd Rep	$81 - $85	200%
Medicaid / KanCare	$81 - $85	200%
Molina Healthcare Of Washington Mcd Rep	$88 - $92	218%
Blue Cross Blue Shield	$104 - $110	257%
Blue Shield Of Wa Regence	$104 - $110	257%
Kaiser Foundation Health Plan Of The Northwest	$110 - $115	272%
First Choice Health Network	$122 - $128	302%
Cigna	$139 - $146	344%

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 $104.
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 Snoqualmie Valley 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.