CMS Price Transparency Data

Prosthetic fitting and training

Facility: Black River Memorial Hospital

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97761
Insurance Median: $114
Cash Discount Price: $113
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a Prosthetic fitting and training at Black River Memorial Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.82x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $113 (280%)

Insurance Median: $114 (282%)

Cash: $113 (280% of Medicare)

Ins. Median: $114 (282% 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 282% of the Medicare baseline (a markup of 182%). 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
Blue Cross Blue Shield	$26 - $110	64%
Group Health Cooperative Of Eau Claire	$26 - $121	64%
Inclusa	$26	64%
My Choice Wisconsin, Inc.	$26 - $64	64%
Quartz Health Solutions, Inc	$26 - $114	64%
UnitedHealthcare	$26 - $118	64%
Humana	$64 - $116	158%
Security Health Plan	$64 - $117	158%
Corvel	$76	188%
The Alliance	$106 - $120	262%
Triology Health Solutions	$112 - $119	277%
Medica	$117	290%
Association Benefits Solution	$119	294%
Family Health Center Of Marshfield	$119	294%
First Health Group Corporation	$119	294%
Provider Network Of America	$119	294%
Cigna	$121	299%
Cofinity	$121	299%
Coventry Health Care	$121	299%
Custom Benefit Administrators	$121	299%
Healthpartners, Inc.	$121	299%
Multiplan	$121 - $124	299%
Wisconsin Physicians Service Insurance Corp	$121	299%
Chorus	$122	302%

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 $113.
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 Black River Memorial 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.