CMS Price Transparency Data

Orthotic fitting and training

Facility: Washington County Hospital and Clinics

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $44
Cash Discount Price: $78
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Washington County Hospital and Clinics is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.95x the Medicare baseline. Located in 400 East Polk Street, Washington, IA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $78 (169%)

Insurance Median: $44 (95%)

Cash: $78 (169% of Medicare)

Ins. Median: $44 (95% 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.

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
Aetna	$38 - $102	82%
Blue Cross Blue Shield	$42 - $249	91%
Health Alliance Mcr Adv	$42	91%
Healthpartners Mcr Adv	$42	91%
Humana	$42	91%
Med Assoc Mcr Adv	$42	91%
Ia Total Care Wellcare Mcr Adv	$43	93%
Molina Mcr Adv - All Other Plans	$43	93%
Wellpoint Mcr Adv Amerigrp - All Other Plans	$43	93%
Ia Total Care Mcaid	$44	95%
Medicaid / KanCare	$44	95%
Wellpoint Mcaid Amerigrp	$44	95%
Ambetter / Centene	$69	150%
Healthpartners - All Other Plans	$88	191%
Midlands Choice - All Plans	$88	191%
Health Alliance Comm - All Other Plans	$99	215%

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 $78.
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 Washington County Hospital and 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.