CMS Price Transparency Data

Orthotic fitting and training

Facility: Anderson Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $63
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Anderson Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.37x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $112 (243%)
Insurance Median: $63 (137%)
Cash: $112 (243% of Medicare)
Ins. Median: $63 (137% 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.

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
Tricare $42 - $43 91%
Aetna $43 - $132 93%
Humana $43 93%
Medicare (plans) $43 - $44 93%
UnitedHealthcare $43 - $203 93%
Clear Springs Health $44 95%
Devoted Health Ppo $44 95%
Essence $44 - $45 95%
Medicaid / KanCare $45 98%
Health Care Service Corporation $57 - $103 124%
Ambetter / Centene $63 137%
Blue Choice $63 137%
Hopetrust $109 236%
Healthlink $112 243%
Self Pay $112 - $25,000 243%
Work Comp $119 - $26,600 258%
Blue Cross Blue Shield $120 - $125 260%
Mercy Benefit Admin $155 336%
Cigna $157 341%
Mercy Aco $160 347%
Multiplan/Phcs $168 365%
Beech Street Corporation $202 438%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals