CMS Price Transparency Data

Orthotic fitting and training

Facility: Mercyone North Iowa Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $68
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercyone North Iowa Medical Center is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.48x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$68

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: $85 (184%)
Insurance Median: $68 (148%)
Cash: $85 (184% of Medicare)
Ins. Median: $68 (148% 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.

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 59%
Medicaid / KanCare $28 61%
Health Choices $33 72%
Medical Associates $33 72%
Aetna $43 - $68 93%
Blue Cross Blue Shield $43 93%
Medicare (plans) $43 - $45 93%
UnitedHealthcare $44 - $350 95%
Centivo $54 117%
Amish Hospital Aid $58 126%
Oscar $58 126%
1199 National Benefit Fund $68 148%
Allied Benefit Systems $68 148%
Asr Health Benefits $68 148%
Christian Brother Services $68 148%
Coventry $68 148%
First Health $68 148%
Lucent Health $68 148%
Luminare Health $68 148%
Medical Mutual $68 148%
Meritain $68 148%
Trustmark Small Business Benefits $68 148%
Webtpa $68 148%
Ambetter / Centene $73 158%
Preferred One $84 182%
Health Partners $87 189%
Claimdoc $88 191%
Nova $88 191%
Auxiant $91 197%
Cigna $91 197%
Medica $91 197%
Midlands $91 197%
Midlands Choice $91 197%
Mhnet $104 226%
Multiplan $117 254%
Crime Victim Assistance $130 282%
Iowa Dept Of Public Health $130 282%
Geha $350 759%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Fourth Street Sw, Mason City, IA 50401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals