CMS Price Transparency Data
Prosthetic fitting and training
Facility: Clovis Community Medical Center
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $43
- Cash Discount Price: $134
- vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Clovis Community Medical Center is $43. 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 1.06x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$134
Average discount available for prompt cash payment at this facility.
Insurance Median
$43
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: $43 (106%)
Cash: $134 (332% of Medicare)
Ins. Median: $43 (106% 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 Shield | $38 - $408 | 94% |
| Central Valley Medical Providers | $42 - $117 | 104% |
| Humana | $43 - $142 | 106% |
| Generic Bscphp | $43 | 106% |
| Blue Shield Saint Agnes | $43 | 106% |
| Cares Act Provider Relief Fund | $43 | 106% |
| Sante | $43 | 106% |
| Healthnet Sante Dual Risk | $43 | 106% |
| Bscphp - First Choice | $43 | 106% |
| Sante Sub Cap-Blue Shield/Sante | $43 | 106% |
| Todays Pyramid | $43 | 106% |
| Kaiser | $43 | 106% |
| Hartford Life Supplement | $43 | 106% |
| Sante-Blue Shield/Sante | $43 | 106% |
| Blue Cross Blue Shield | $43 - $106 | 106% |
| Blue Shield Promise - Imperial | $43 | 106% |
| Generic | $43 | 106% |
| Blue Shield Sante | $43 | 106% |
| Care1St HMO - Ehs | $43 | 106% |
| Brand New Day | $43 | 106% |
| Gemcare HMO | $43 | 106% |
| Healthnet Sante - Sub Cap Dual Risk | $43 | 106% |
| Us Marshal | $43 | 106% |
| Blue Shield 65 Plus HMO Ehs | $43 | 106% |
| Healthnet HMO - La Salle | $43 | 106% |
| Community Care | $43 | 106% |
| Wellcare | $43 | 106% |
| Blue Shield Hmo-Cvmp/Medpro | $43 | 106% |
| Railroad Part A | $43 | 106% |
| Blue Shield 65 Plus HMO First Choice | $43 | 106% |
| Railroad Part A & B | $43 | 106% |
| Railroad Part B | $43 | 106% |
| Healthnet Sante | $43 | 106% |
| Medicare (plans) | $43 | 106% |
| Healthnet HMO - Dhmso | $43 | 106% |
| Healthnet HMO - Sante | $43 | 106% |
| Sante-Healthnet Seniority | $43 | 106% |
| Scan Health Plan | $43 | 106% |
| Sante Sub Cap Healthnet Seniority | $43 | 106% |
| Victims of Crime | $43 | 106% |
| Sante-Sub Cap Ma Brand New Day | $43 | 106% |
| Bscphp HMO - First Choice | $43 | 106% |
| Aetna | $43 - $102 | 106% |
| Healthnet HMO - Cvmp/Medpro | $43 | 106% |
| Meritage Blue Shield 65 Plus | $43 | 106% |
| Sequoia Pace - Peak Tpa | $43 | 106% |
| Medi-Cal Innovative Integrated Health | $43 | 106% |
| Meritage Brand New Day | $43 | 106% |
| Meritage Healthnet HMO | $43 | 106% |
| Cigna | $43 - $419 | 106% |
| Advantek Table Mountain Rancheria Tribal Member | $43 | 106% |
| Generic Victims of Crime | $43 | 106% |
| Bscphp - Dhmso | $43 | 106% |
| UnitedHealthcare | $43 - $377 | 106% |
| Well Path (Cfmg) | $43 - $184 | 106% |
| Innovative Integrated Health Community Plans HMO | $47 | 116% |
| Champion Health Plan of California Ma | $47 | 116% |
| Alignment Health Plan | $47 | 116% |
| Imperial Health Plan HMO | $49 | 121% |
| Correctcare Integrated Health | $56 | 139% |
| Employer 90/40 | $67 | 166% |
| Coalinga State Hospital | $86 | 213% |
| Nx Health Network PPO | $92 | 228% |
| Naphcare Inc-Mendota | $92 | 228% |
| Central Ca Indian Health | $92 | 228% |
| Healthsmart | $114 - $134 | 282% |
| Coventry Health Care (First Health Network) | $125 | 309% |
| Network By Design | $125 | 309% |
| Generic Multiplan | $142 | 351% |
| PHCS | $142 | 351% |
| Physmetrics Health | $285 | 705% |
| Healthnet | $353 - $372 | 874% |