CMS Price Transparency Data

Orthotic fitting and training

Facility: Eastern Idaho Regional Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $71
Cash Discount Price: $171
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Eastern Idaho Regional Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.54x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $171 (371%)

Insurance Median: $71 (154%)

Cash: $171 (371% of Medicare)

Ins. Median: $71 (154% 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
Blue Cross Blue Shield	$37 - $162	80%
Molina	$37 - $44	80%
Prime Health	$38 - $145	82%
Regence Blue Shield	$38 - $44	82%
Rexburg Care And Rehab	$38 - $44	82%
Triwest Healthcare Alliance	$38 - $44	82%
Veteran'S Administration	$38 - $44	82%
Humana	$39 - $143	85%
United	$39 - $99	85%
Select Health	$52	113%
Select Health Ichn Brightpath	$52 - $58	113%
Select Health Idaho (Eirmc Only)	$54	117%
Aetna	$67 - $83	145%
Doug Andrus Distributing	$68	148%
Regence	$71	154%
Pacificsource Health	$72 - $92	156%
University Of Utah	$72	156%
Mountain Health Co-Op	$85 - $128	184%
Cigna	$94	204%
First Choice Health Of Washington	$102	221%
Moda	$106	230%
Dmba	$110	239%
Geha Ppo Usa	$137	297%
Multiplan	$143 - $154	310%
First Choice Of The Midwest	$154	334%
Interwest Health	$154	334%
St. John'S Health Network	$154	334%
Coventry First Health	$155	336%
Shashone-Bannock Tribal Health	$171	371%

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 $171.
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 Eastern Idaho Regional Medical 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.