CMS Price Transparency Data

Orthotic fitting and training

Facility: Cass County Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $55
Cash Discount Price: $90
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Cass County Memorial Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.19x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$90

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: $90 (195%)

Insurance Median: $55 (119%)

Cash: $90 (195% 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.

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
Midlands Choice Medica Mcr	$26	56%
Triwest - All Plans	$52	113%
Aetna	$54 - $122	117%
Amerigroup Mcr Adv - All Other Plans	$54	117%
Medica Mcr Adv	$54	117%
Tricare	$54	117%
UnitedHealthcare	$54 - $116	117%
Va Ccn - All Plans	$54	117%
Wellmark Mcr Adv	$54	117%
American Hlth Mcr Adv - All Plans	$55	119%
Iowa Total Care Mcaid	$55	119%
Iowa Total Care Mcr	$55	119%
Medicaid / KanCare	$55	119%
Molina Mcaid - All Plans	$55	119%
Iowa Total Care Comm - All Other Plans	$59	128%
Midlands Choice New Bus	$83	180%
Medica Comm - All Other Plans	$113	245%
Midlands Choice Pho (Ppo) - All Other Plans	$115	250%
Multiplan - All Plans	$122	265%
Wellmark Hmo	$158	343%
Wellmark Ppo - All Other Plans	$174	378%

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 $90.
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 Cass County Memorial Hospital 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.