Prosthetic fitting and training
Facility: Watsonville Community Hospital
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $215
- Cash Discount Price: $205
- vs. Medicare Baseline: 5.32x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 532% of the Medicare baseline (a markup of 432%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Hartford Workers' Comp | $46 | 114% |
| Keenan & Assoc Work Comp | $46 | 114% |
| Workers Comp | $46 | 114% |
| Secure Horizons | $46 | 114% |
| Travelers Insurance | $46 - $342 | 114% |
| Blue Shield PPO | $46 | 114% |
| Republic Idemnity W/Comp | $46 | 114% |
| Western Growers Work Comp | $46 | 114% |
| Liberty Mutual Work Comp | $46 | 114% |
| Ace-Usa | $46 | 114% |
| Medicare (plans) | $46 | 114% |
| Miscellaneous Work Comp | $46 | 114% |
| Crawford & Co | $46 | 114% |
| Tricare | $46 | 114% |
| Fireman's Fund Work Comp | $46 | 114% |
| UnitedHealthcare | $46 - $205 | 114% |
| Health Net of California | $46 - $215 | 114% |
| Gallagher Bassett Svcs | $46 | 114% |
| U.S. Dept. of Labor | $46 | 114% |
| Veterans Administration | $46 | 114% |
| Pinnacle Healthcare Uc | $46 | 114% |
| Alignment Health Plan | $46 | 114% |
| Secure Horizons Dign HMO | $46 - $68 | 114% |
| Fleming & Associates | $46 | 114% |
| Beta Healthcare Group | $46 | 114% |
| Kemper Group Workers Comp | $46 | 114% |
| Medicruz | $62 | 153% |
| Victim Compensation Plan | $62 - $342 | 153% |
| Great-West/Phcs | $68 - $240 | 168% |
| Blue Cross Blue Shield | $68 - $305 | 168% |
| Health Net Pmg HMO | $68 - $215 | 168% |
| Cigna | $68 - $240 | 168% |
| Blue Shield HMO | $68 | 168% |
| Pacificare HMO | $68 - $205 | 168% |
| Aetna | $68 - $281 | 168% |
| Western Growers Trust/Bc | $137 - $305 | 339% |
| Pinnacle Claims Tpa/Bc | $137 - $305 | 339% |
| Kaiser Northern | $150 | 371% |
| Western Health Advantage | $171 | 423% |
| Pacificare PPO | $205 | 507% |
| Self Pay | $205 | 507% |
| Health Net Smartcare Netw | $205 | 507% |
| Health Net Blue and Gold | $215 | 532% |
| Health Net Canopycare HMO | $215 | 532% |
| First Health | $240 - $274 | 594% |
| Adventist Risk Management | $240 - $274 | 594% |
| Geha (Ccn) | $240 - $274 | 594% |
| Transwestern | $240 - $274 | 594% |
| Multiplan Inc PPO | $267 | 661% |
| Private Healthcare System | $267 | 661% |
| Salinas Valley Mem Hops | $291 | 720% |
| Coastal Healthcare Admin | $291 - $308 | 720% |
| Carpenters H&W Trust | $297 - $305 | 735% |
| Teamsters Benefit Trust | $297 - $305 | 735% |
| Monterey Bay Pub Emp Trst | $297 - $305 | 735% |
| City of Wats/Pinnacle Clm | $297 - $305 | 735% |
| Calif Ironworkers Field | $297 - $305 | 735% |
| Claims Management Wc | $297 - $305 | 735% |
| Delta Health Systems | $297 - $305 | 735% |
| State Compensation Fund | $297 - $305 | 735% |
| Laborers Health & Welfare | $297 - $305 | 735% |
| Robert Kennedy/Ccn | $297 - $305 | 735% |
| Operating Engineers | $297 - $305 | 735% |
| Sheet Metal Workers | $297 - $305 | 735% |
| Farmers Insurance | $342 | 846% |
| Apwu Health Plan | $342 | 846% |
| Prucare Pmg HMO | $342 | 846% |
| Wholesale Beer Distributo | $342 | 846% |
| Physicians Mutual | $342 | 846% |
| Zenith National Ins | $342 | 846% |
| Aarp | $342 | 846% |
| Allstate | $342 | 846% |
| Prucare Pmg POS | $342 | 846% |
| Miscellaneous Auto | $342 | 846% |
| Miscellaneous Insurance | $342 | 846% |
| United Administrative | $342 | 846% |
| Well Path | $342 | 846% |
| Bankers Life & Casualty | $342 | 846% |
| Aaa | $342 | 846% |
| North Calif Bakery Driver | $342 | 846% |
| Humana | $342 | 846% |
| Sutter Health Plus | $342 | 846% |
| State Farm Ins | $342 | 846% |