CMS Price Transparency Data

Orthotic fitting and training

Facility: Hamilton Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $67
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Hamilton Memorial Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.45x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $74 (161%)
Insurance Median: $67 (145%)
Cash: $74 (161% of Medicare)
Ins. Median: $67 (145% 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
Medicaid / KanCare $32 - $35 69%
Blue Cross Blue Shield $33 - $79 72%
Aetna $35 - $78 76%
Health Alliance $35 - $70 76%
Humana $35 76%
Medicare (plans) $35 - $44 76%
UnitedHealthcare $35 - $62 76%
Wellcare $35 - $44 76%
Alliance Coal $61 132%
Healthscope $61 132%
Wellfirst (Ssmhic) $61 132%
Hope Trust $65 141%
Cigna $68 148%
Hfn, Inc $70 - $78 152%
Healthlink $74 - $78 161%
Multiplan $74 161%
Siho $78 169%
Three Rivers Provider $78 169%
Healthsmart $83 180%
Stratose $83 180%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals