CMS Price Transparency Data

Orthotic fitting and training

Facility: Kossuth Regional Health Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $105
Cash Discount Price: $100
vs. Medicare Baseline: 2.28x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Kossuth Regional Health Center is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.28x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $100 (217%)

Insurance Median: $105 (228%)

Cash: $100 (217% of Medicare)

Ins. Median: $105 (228% 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 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$45 - $50	98%
Mercy One - All Plans	$45 - $50	98%
Va Ccn - All Plans	$45 - $50	98%
Amerigroup Mcr Adv - All Other Plans	$46 - $51	100%
UnitedHealthcare	$46 - $99	100%
Health Partners New Bus - All Other Plans	$83 - $92	180%
Midlands Choice - All Plans	$83 - $92	180%
Medical Associates - All Plans	$100 - $111	217%
Preferred Health - All Plans	$100 - $111	217%
Aetna	$110 - $127	239%
Multiplan - All Plans	$112 - $124	243%
Health Partners Exisiting Bus	$114 - $127	247%
Molina Mcaid/Chip - All Plans	$122 - $135	265%
Amerigroup Mcaid	$123 - $136	267%
Blue Cross Blue Shield	$191 - $210	414%

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 $100.
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 Kossuth 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.