CMS Price Transparency Data

Orthotic fitting and training

Facility: Sanford Sheldon Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $108
  • Cash Discount Price: $134
  • vs. Medicare Baseline: 2.34x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Sanford Sheldon Medical Center is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.34x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.
Cash / Self-Pay
$134

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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: $134 (291%)
Insurance Median: $108 (234%)
Cash: $134 (291% of Medicare)
Ins. Median: $108 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Sanford Health Plan Align $48 104%
Ucare $51 - $148 111%
Aetna $52 - $146 113%
Blue Cross Blue Shield $52 113%
Health Partners $52 - $126 113%
Medicare (plans) $52 113%
UnitedHealthcare $52 - $140 113%
Primewest $53 115%
Wellmark $84 - $87 182%
Sanford Health Plan $90 - $106 195%
Security Health Plan $92 200%
Medica $139 - $148 302%
First Choice Health Network $151 328%
Healthez $151 328%
Multiplan $151 328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 118 North Seventh Avenue, Po Box 250, Sheldon, IA 51201
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals