CMS Price Transparency Data

Orthotic fitting and training

Facility: Veterans Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $55
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Veterans Memorial Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.19x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $73 (158%)
Insurance Median: $55 (119%)
Cash: $73 (158% of Medicare)
Ins. Median: $55 (119% 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
Amerigroup Mcaid - All Other Plans $43 93%
Amerigroup Mcr Adv $55 119%
Humana $55 - $96 119%
Iowa Total Care Exchange $55 119%
Iowa Total Care Mcr Adv $55 119%
Medica Mcr Adv $55 119%
Molina Mcr Adv $55 119%
Quartz Mcr Adv $55 119%
UnitedHealthcare $55 - $109 119%
Welmark Mcr Adv $55 119%
Iowa Total Care Mcaid - All Other Plans $65 141%
Molina Mcaid - All Other Plans $65 141%
Aetna $86 187%
Quartz Comm - All Other Plans $96 208%
Wellmark Hmo - All Other Plans $167 362%
Wellmark Ppo $184 399%
Medica Comm - All Other Plans $235 510%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 40 1St Street Se, Waukon, IA 52172
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals