CMS Price Transparency Data

Prosthetic fitting and training

Facility: Marshfield Medical Center

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $141
Cash Discount Price: $143
vs. Medicare Baseline: 3.49x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Marshfield Medical Center is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 3.49x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $143 (354%)

Insurance Median: $141 (349%)

Cash: $143 (354% of Medicare)

Ins. Median: $141 (349% 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 349% of the Medicare baseline (a markup of 249%). 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
Family Health Center (Fhc)	$75	186%
Amish/Mennonite	$82	203%
Sanford Health Plan	$82	203%
The Alliance	$104 - $125	257%
Blue Cross Blue Shield	$114 - $132	282%
Security Health Plan (Shp)	$120 - $177	297%
Group Health Cooperative Of Eau Claire	$123 - $138	304%
Besse Forest Products	$128	317%
Molina Healthcare Of Wi	$128	317%
Rice Lake School District	$128	317%
Wps Health Insurance	$132 - $145	327%
Trilogy	$135 - $144	334%
UnitedHealthcare	$136	337%
Medica Of Wi	$139 - $142	344%
Cigna	$141	349%
Healtheos By Multiplan Inc.	$141 - $142	349%
Corvel	$142	351%
First Health	$142	351%
Health Partners	$142	351%
Three Rivers Provider Network (Trpn)	$142	351%
Coventry	$144	356%
Health Smart	$144	356%
Rising Medical Work Comp	$146	361%

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 $143.
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 Marshfield 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.