CMS Price Transparency Data

Orthotic fitting and training

Facility: Mercyone Clinton Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $77
  • Cash Discount Price: $77
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercyone Clinton Medical Center is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.67x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$77

Average discount available for prompt cash payment at this facility.

Insurance Median
$77

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: $77 (167%)
Insurance Median: $77 (167%)
Cash: $77 (167% of Medicare)
Ins. Median: $77 (167% 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
Health Choices $24 - $43 52%
Medical Associates $24 - $43 52%
Preferred Health Choice $25 - $44 54%
Iowa Total Care $27 59%
Medicaid / KanCare $28 61%
Aetna $43 - $133 93%
Blue Cross Blue Shield $43 93%
Medicare (plans) $43 - $45 93%
UnitedHealthcare $44 - $461 95%
The Alliance $52 - $92 113%
Amish Hospital Aid $58 126%
Oscar $60 130%
Ambetter / Centene $73 158%
1199 National Benefit Fund $74 - $133 161%
Allied Benefit Systems $74 - $133 161%
Asr Health Benefits $74 - $133 161%
Christian Brother Services $74 - $133 161%
Coventry $74 - $133 161%
First Health $74 - $133 161%
Lucent Health $74 - $133 161%
Luminare Health $74 - $133 161%
Medical Mutual $74 - $133 161%
Meritain $74 - $133 161%
Trustmark Small Business Benefits $74 - $133 161%
Webtpa $74 - $133 161%
Health Partners $75 - $133 163%
Auxiant $76 - $137 165%
Cigna $76 - $137 165%
Medica $76 - $137 165%
Midlands $76 - $137 165%
Midlands Choice $76 - $137 165%
Multiplan $76 - $137 165%
Qualcare $76 - $137 165%
Usa Managed Care $81 - $144 176%
Crime Victim Assistance $85 - $152 184%
Iowa Dept Of Public Health $85 - $152 184%
Claimdoc $88 191%
Nova $88 191%
Geha $195 - $461 423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals