CMS Price Transparency Data

Orthotic fitting and training

Facility: Clarinda Regional Health Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $60
Cash Discount Price: $64
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Clarinda Regional Health Center is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.30x the Medicare baseline. Located in 220 Essie Davison Drive, Clarinda, IA.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

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: $64 (139%)

Insurance Median: $60 (130%)

Cash: $64 (139% of Medicare)

Ins. Median: $60 (130% 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
Ambetter / Centene	$49 - $59	106%
Molina Mcr Adv-All Plans	$49 - $55	106%
UnitedHealthcare	$49 - $108	106%
Blue Cross Blue Shield	$50 - $91	108%
Ia Total Care Mcaid-All Plans	$54 - $60	117%
Geha-All Plans	$96 - $106	208%
Coventry Health-All Other Plans	$97 - $107	210%
Midlands Choice-All Plans	$98 - $108	213%
Multiplan-All Plans	$98 - $108	213%
Amerigroup Ia Mcaid-All Plans	$103 - $114	223%

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 $64.
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 Clarinda Regional Health Center 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.