CMS Price Transparency Data

Orthotic fitting and training

Facility: Mercy Medical Center-New Hampton

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $187
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 4.06x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercy Medical Center-New Hampton is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.06x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$187

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: $129 (280%)
Insurance Median: $187 (406%)
Cash: $129 (280% of Medicare)
Ins. Median: $187 (406% 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 406% of the Medicare baseline (a markup of 306%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $78 169%
Aetna $79 - $187 171%
Medicare (plans) $80 - $88 174%
UnitedHealthcare $84 - $137 182%
Health Choices $100 217%
Medical Associates $100 217%
Amish Hospital Aid $105 228%
Oscar $116 252%
Ambetter / Centene $133 289%
Iowa Total Care $135 293%
Geha $137 297%
Medicaid / KanCare $137 - $138 297%
Claimdoc $159 345%
Nova $159 345%
1199 National Benefit Fund $187 406%
Allied Benefit Systems $187 406%
Asr Health Benefits $187 406%
Coventry $187 406%
First Health $187 406%
Lucent Health $187 406%
Luminare Health $187 406%
Medical Mutual $187 406%
Meritain $187 406%
Trustmark Small Business Benefits $187 406%
Webtpa $187 406%
First Choice Health $188 408%
Health Partners $190 412%
Auxiant $192 417%
Cigna $192 417%
Medica $192 417%
Midlands $192 417%
Midlands Choice $192 417%
Crime Victim Assistance $198 430%
Iowa Dept Of Public Health $198 430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 308 North Maple Avenue, New Hampton, IA 50659
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals