CMS Price Transparency Data

Orthotic fitting and training

Facility: Nell J Redfield Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $88
Cash Discount Price: $104
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Nell J Redfield Memorial Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.91x the Medicare baseline. Located in 150 North 200 West, Malad City, ID.

Cash / Self-Pay

$104

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $104 (226%)

Insurance Median: $88 (191%)

Cash: $104 (226% of Medicare)

Ins. Median: $88 (191% 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
Regence Bs Mcr	$52 - $70	113%
UnitedHealthcare	$52 - $119	113%
Bc Mcr Adv	$53 - $71	115%
Choicecare Mcr Adv	$53 - $71	115%
Aetna	$54 - $115	117%
Pacificsource Mcr Adv - All Plans	$54 - $72	117%
University Of Ut - All Plans	$84 - $112	182%
Choicecare Ppo - All Other Plans	$89 - $119	193%
Town & Country - All Plans	$89 - $119	193%
Brightpath Select Hlth - All Plans	$94 - $126	204%
Regence Bs Comm - All Other Plans	$100 - $133	217%
Bc Comm - All Other Plans	$103 - $137	223%

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 $104.
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 Nell J Redfield 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.