CMS Price Transparency Data

Orthotic fitting and training

Facility: Spanish Peaks Regional Health Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $67
Cash Discount Price: $102
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Spanish Peaks Regional Health Center is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.45x the Medicare baseline. Located in 23500 Us Highway 160, Walsenburg, CO.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $102 (221%)

Insurance Median: $67 (145%)

Cash: $102 (221% of Medicare)

Ins. Median: $67 (145% 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.

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
Humana	$48 - $59	104%
Kaiser Ppo Mcr	$48 - $120	104%
Medicare (plans)	$48 - $59	104%
UnitedHealthcare	$48 - $112	104%
Devoted Health Mcr - All Plans	$50 - $62	108%
Beacon Health Op Only-All Plans	$56 - $107	122%
Blue Cross Blue Shield	$59 - $108	128%
Apostrophe - All Plans	$62 - $108	135%
Cofinity - All Plans	$62 - $110	135%
Connect For Health - All Plans	$62 - $112	135%
Friday Hp Chp - All Plans	$62 - $108	135%
Prov Ntwrk Of America - All Plans	$67 - $108	145%
Rmhp - All Plans	$72 - $112	156%
Kaiser Ppo - All Other Plans	$77 - $108	167%
Cigna	$96 - $108	208%
Multiplan Phcs - All Plans	$96 - $114	208%

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 $102.
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 Spanish Peaks Regional Health Center 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.