Prosthetic fitting and training
Facility: Mount Sinai Rehabilitation Hospital Inc
Billing Code: 97761 (CPT)
- CPT Billing Code: 97761
- Insurance Median: $158
- Cash Discount Price: $128
- vs. Medicare Baseline: 3.91x 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 391% of the Medicare baseline (a markup of 291%). 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 |
|---|---|---|
| Medicare (plans) | $42 - $44 | 104% |
| Aetna | $42 - $299 | 104% |
| UnitedHealthcare | $42 - $224 | 104% |
| Blue Cross Blue Shield | $42 - $233 | 104% |
| Cca Senior Care Options | $43 | 106% |
| Cigna | $43 - $129 | 106% |
| Innovative Health Plan II | $90 | 223% |
| Claimdoc | $90 | 223% |
| Diversified Administrators | $90 | 223% |
| Connecticut Dept of Correction | $101 | 250% |
| Health New England | $124 | 307% |
| Magnacare | $129 | 319% |
| Allegiance | $129 | 319% |
| Health Partners | $129 | 319% |
| Allied National Global Care | $158 | 391% |
| Dean Health | $158 | 391% |
| Multiplan | $158 | 391% |
| Trinity Health Share | $158 | 391% |
| Ghc Scw | $158 | 391% |
| Pan-American Life | $158 | 391% |
| Asrm - Reliance Standard Life Insurance | $158 | 391% |
| Manhattan Life | $158 | 391% |
| Lifetime Benefit Solutions | $158 | 391% |
| Family Life Insurance Company | $158 | 391% |
| Medi Share | $158 | 391% |
| International Benefit Administrators | $158 | 391% |
| Pai | $158 | 391% |
| Paramount HMO | $158 | 391% |
| Christian Care Ministry | $158 | 391% |
| PHCS | $158 | 391% |
| Mvp | $158 | 391% |
| Prime Health Services | $186 | 460% |
| Health Smart | $198 | 490% |
| Geha | $224 | 554% |
| Harvard Pilgrim Healthcare | $224 | 554% |
| Health Choices | $233 | 577% |
| Unicare | $233 | 577% |
| Pre-Employment | $233 | 577% |
| Bcn Domestic | $233 | 577% |
| Blue Shield - Wa (Regence) | $233 | 577% |
| Blue Shield - Id (Regence) | $233 | 577% |
| Blue Benefit Administrators of Massachusetts | $233 | 577% |
| Blue Care Network | $233 | 577% |
| Wc Domestic | $233 | 577% |
| Blue Shield - Ny Highmark Western | $233 | 577% |
| Blue Distinction Transplant | $233 | 577% |
| Blue Shield - PA (Highmark) | $233 | 577% |
| Kaiser Domestic | $233 | 577% |
| Blue Shield - Ny Highmark Northeastern | $233 | 577% |
| Blue Shield - Ca | $233 | 577% |
| Allied Benefit Systems | $299 | 740% |
| Meritain | $299 | 740% |
| 1199 National Benefit Fund | $299 | 740% |
| Luminare Health | $299 | 740% |
| Gravie Admin Services | $299 | 740% |
| Nippon Life Ins | $299 | 740% |
| Webtpa | $299 | 740% |
| Hap | $299 | 740% |
| Connecticare | $354 - $402 | 876% |