CMS Price Transparency Data

Orthotic fitting and training

Facility: Sarah Bush Lincoln Health Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $178
  • Cash Discount Price: $241
  • vs. Medicare Baseline: 3.86x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Sarah Bush Lincoln Health Center is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.86x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$241

Average discount available for prompt cash payment at this facility.

Insurance Median
$178

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: $241 (523%)
Insurance Median: $178 (386%)
Cash: $241 (523% of Medicare)
Ins. Median: $178 (386% 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 386% of the Medicare baseline (a markup of 286%). 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
Aetna $44 - $217 95%
Bc Comm Mmai $44 95%
Beacon Health Options Behav-All Plans $44 95%
Hlth Alliance Mcr Adv $44 95%
Humana $44 - $45 95%
Meridian Mmai-All Other Plans $44 95%
Molina Mmai-All Other Plans $44 95%
Tricare $44 95%
UnitedHealthcare $44 - $200 95%
Va Ccn-All Plans $44 95%
Wellcare Med Adv-All Plans $44 95%
Bc Comm Care Mcaid $45 98%
Bc Med Adv Ppo/Hmo $45 98%
Hlth Alliance Mcaid $45 98%
Meridian Mcaid $45 98%
Molina Mcaid $45 98%
Plain Church Mg-All Plans $96 208%
Mennonite-All Plans $108 234%
Eiu Athlete-All Other Plans $169 367%
Healthscope-All Plans $178 386%
Rural King-All Plans $178 386%
Blue Cross Blue Shield $190 - $193 412%
Consociate-All Plans $193 419%
Hope Trust-All Plans $193 419%
Eiu Student $198 430%
Allied National-All Plans $202 438%
Companion Life-All Plans $202 438%
Hlth Alliance-All Other Plans $202 438%
First Health-All Plans $205 445%
Innovative Hlthware-All Plans $205 445%
Healthlink Hmo $207 449%
Healthlink Ppo - All Other Plans $207 449%
Multiplan-All Plans $207 449%
Cigna $217 471%
Cphp-All Plans $217 471%
Beech Street-All Plans $222 482%
Hfn-All Plans $222 482%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals