CMS Price Transparency Data

Orthotic fitting and training

Facility: Portneuf Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $82
Cash Discount Price: $82
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Portneuf Medical Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.78x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $82 (178%)

Insurance Median: $82 (178%)

Cash: $82 (178% of Medicare)

Ins. Median: $82 (178% 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
Black Lung [6055]	$56	122%
Employee Benefit Management Services [2445]	$56 - $82	122%
Healthcare Highways [2210]	$56	122%
Lucent Health [6000]	$56	122%
Moda Health [6100]	$56	122%
Oncology Patient Assistance Programs [2295]	$56	122%
Pending Ssi [1616]	$56	122%
Web Tpa [2115]	$56	122%
Pacific Source Health Plans [2850]	$79	171%
Medishare Christian Care [1645]	$82	178%
Multiplan [1680]	$92	200%
Worker'S Comp [2125]	$100 - $103	217%
Enablecomp [1350]	$103	223%
Transamerican Life [1990]	$103	223%
Geha [1415]	$123	267%
UnitedHealthcare	$123	267%

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 $82.
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 Portneuf 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.