CMS Price Transparency Data

Orthotic fitting and training

Facility: Fayette County Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $146
  • Cash Discount Price: $224
  • vs. Medicare Baseline: 3.17x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Fayette County Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.17x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.
Cash / Self-Pay
$224

Average discount available for prompt cash payment at this facility.

Insurance Median
$146

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: $224 (486%)
Insurance Median: $146 (317%)
Cash: $224 (486% of Medicare)
Ins. Median: $146 (317% 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 317% of the Medicare baseline (a markup of 217%). 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 $71 - $155 154%
Blue Cross Blue Shield $71 - $188 154%
Illinicare - All Plans $71 154%
Medicaid / KanCare $71 154%
Meridian-All Plans $71 154%
Health Alliance Mcare $72 156%
Healthlink Mcr Adv $72 156%
Humana $72 156%
Coventry/Ghp-All Plans $146 317%
Healthlink Hmo $157 341%
Cigna $168 365%
Healthlink Ppo - All Other Plans $179 388%
Health Alliance - All Other Plans $185 401%
UnitedHealthcare $186 404%
Multiplan - All Plans $190 412%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 650 W Taylor St, Vandalia, IL 62471
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals