CMS Price Transparency Data

Orthotic fitting and training

Facility: Hammond Henry Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $113
Cash Discount Price: $136
vs. Medicare Baseline: 2.45x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Hammond Henry Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.45x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $136 (295%)

Insurance Median: $113 (245%)

Cash: $136 (295% of Medicare)

Ins. Median: $113 (245% 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 245% of the Medicare baseline (a markup of 145%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tricare	$39	85%
Aetna	$44 - $113	95%
Health Alliance Mcare Adv	$44	95%
UnitedHealthcare	$44 - $133	95%
Wellmark Of Ia-All Plans	$76	165%
Blue Cross Blue Shield	$83 - $91	180%
Meridian Health Plan-All Plans	$86	187%
Quad City Community Hc-All Plans	$90	195%
Springfield Armory-All Plans	$98	213%
Ambetter / Centene	$106	230%
Health Alliance-All Other Plans	$113	245%
Multiplan Integrated Hp	$113	245%
Cigna	$116	252%
Humana	$120	260%
Multiplan Pponext	$121	263%
Osf Direct Access Network-All Plans	$121	263%
Multiplan-All Other Plans	$128	278%
Corvel-All Plans	$136	295%
Healthsmart Adult-All Other Plans	$136	295%
Healthsmart Pediatric	$136	295%
Hfn-All Plans	$136	295%
Multiplan Beech Street	$136	295%
Multiplan Phcs Adult	$136	295%
Multiplan Phcs Pediatric	$136	295%
Usa Mco-All Plans	$136	295%

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 $136.
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 Hammond Henry 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.