CMS Price Transparency Data

Orthotic fitting and training

Facility: Mercy Rehabilitation Hospital Northwest Arkansas

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $103
Cash Discount Price: $118
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercy Rehabilitation Hospital Northwest Arkansas is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.23x the Medicare baseline. Located in 4313 S Pleasant Crossing Blvd, Rogers, AR.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$46.09

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $46.09 (100%)

Cash / Self-Pay: $118 (256%)

Insurance Median: $103 (223%)

Cash: $118 (256% of Medicare)

Ins. Median: $103 (223% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $46.09 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 223% of the Medicare baseline (a markup of 123%). 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
Phcs	$74 - $113	161%
Multiplan	$79 - $122	171%
Aetna	$93 - $143	202%
Ambetter / Centene	$93 - $143	202%
American Health Plan	$93 - $143	202%
Arkansas Total Care (Passe)	$93 - $143	202%
Blue Cross Blue Shield	$93 - $143	202%
Care Source (Passe)	$93 - $143	202%
Cigna	$93 - $143	202%
Devoted	$93 - $143	202%
Empower	$93 - $143	202%
Essence	$93 - $143	202%
Humana	$93 - $143	202%
Medicaid / KanCare	$93 - $143	202%
Medicare (plans)	$93 - $143	202%
Municipal League	$93 - $143	202%
Qualchoice	$93 - $143	202%
Summit (Passe)	$93 - $143	202%
UnitedHealthcare	$93 - $143	202%
Vaccn	$93 - $143	202%

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 $118.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97760.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Rehabilitation Hospital Northwest Arkansas is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97760.
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.