Prosthetic fitting and training
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $61
- Cash Discount Price: $102
- vs. Medicare Baseline: 1.51x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthy Blue Kansas | $20 - $38 | 49% |
| Medicaid / KanCare | $20 - $81 | 49% |
| Aetna | $20 - $38 | 49% |
| United | $20 - $115 | 49% |
| Missouri Healthnet | $27 | 67% |
| Healthy Blue Missouri | $36 | 89% |
| United Community Of Missouri | $36 | 89% |
| Home State Health Plan | $36 | 89% |
| Humana | $38 | 94% |
| Blue Cross Blue Shield | $38 - $61 | 94% |
| Ilumed Aco Reach | $38 | 94% |
| Velocity | $46 - $76 | 114% |
| Prime Health Services | $49 - $87 | 121% |
| Americas Choice Provider Network | $71 | 176% |
| Provider Network Of America | $76 | 188% |
| Usa Managed Care Organization | $76 | 188% |
| Quiktrip Corporation | $76 | 188% |
| Multiplan-Phcs | $81 | 200% |
| Medincrease | $92 | 228% |
| Cigna | $104 | 257% |
| Providrs Care | $115 | 285% |
Consumer Guidance & Cost Commentary
For the CPT code 97761, "Prosthetic fitting and training," the Rehabilitation Hospital Of Overland Park lists a cash price of $102.00. This cash rate is identical to the facility's Medicare benchmark of $40.41, which serves as the objective baseline for evaluating hospital pricing markups. While commercial insurance contracts often result in negotiated rates that exceed cash prices due to administrative costs and contract dynamics, patients with high-deductible plans may find paying out-of-pocket cheaper if the insurance allowed amount surpasses the cash rate. It is important to note that while the facility is a Part A provider in Overland Park, KS, specific negotiated rates vary significantly by payer, ranging from $20 to $115 across 21 different plans, meaning the actual cost depends entirely on your specific insurance contract.
Before scheduling, patients should verify whether their specific plan has a negotiated rate that exceeds the $102.00 cash price, as paying cash upfront can sometimes be more cost-effective. Additionally, patients should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full within a short window, bypassing the costly insurance claims process. If you are billed for this service, you should request a full itemized CPT-coded statement rather than accepting a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a balance bill from an out-of-network provider at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for