CMS Price Transparency Data

Prosthetic fitting and training

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $120
Cash Discount Price: $134
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.97x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $134 (332%)

Insurance Median: $120 (297%)

Cash: $134 (332% of Medicare)

Ins. Median: $120 (297% 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 297% of the Medicare baseline (a markup of 197%). 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
The Alliance	$72	178%
Security Health Plan (Shp)	$73 - $81	181%
Amish/Mennonite	$78	193%
Quartz	$80	198%
Wps Health Insurance	$95 - $119	235%
Cigna	$96 - $104	238%
Health Payment Systems	$98	243%
Humana	$111 - $125	275%
Group Health Cooperative Of Eau Claire	$116 - $134	287%
Network Health Plan	$118	292%
First Health	$120	297%
Molina Healthcare Of Wi	$120	297%
Trilogy	$127	314%
Healtheos By Multiplan Inc.	$131 - $134	324%
Health Partners	$134	332%
Coventry	$135	334%
UnitedHealthcare	$253	626%
Blue Cross Blue Shield	$318 - $477	787%

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 $134.
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 - Beaver Dam (Mmc-Bd) 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.