CMS Price Transparency Data

Orthotic fitting and training

Facility: University of Iowa Hospital & Clinics

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $139
Cash Discount Price: $165
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at University of Iowa Hospital & Clinics is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.02x the Medicare baseline. Located in 200 Hawkins Drive, Iowa City, IA.

Cash / Self-Pay

$165

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $165 (358%)

Insurance Median: $139 (302%)

Cash: $165 (358% of Medicare)

Ins. Median: $139 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
Iowa Total Care	$27 - $45	59%
Molina Healthcare	$27 - $43	59%
Wellpoint (Amerigroup)	$27 - $45	59%
Immergrun	$42 - $59	91%
Aetna	$43 - $181	93%
Medical Associates	$43 - $157	93%
UnitedHealthcare	$43 - $179	93%
Blue Cross Blue Shield	$44 - $113	95%
Healthpartners	$44 - $200	95%
American Health Plan	$45 - $118	98%
Quad City Community Healthcare	$57 - $176	124%
Midlands Choice	$89 - $153	193%
Oscar Health	$105 - $148	228%
Aplos Health Plan	$112 - $188	243%
Great River Health Systems	$116 - $164	252%
Sedgwick	$133 - $188	289%
Global Excel	$141 - $200	306%
Sanford Health Plan	$141 - $200	306%
Employee Benefit Systems	$146 - $212	317%
Sisco	$146 - $207	317%
Healthsmart	$149 - $212	323%
Hfn	$153 - $216	332%
Multiplan	$153 - $216	332%

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 $165.
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 University of Iowa Hospital & Clinics 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.