CMS Price Transparency Data

Orthotic fitting and training

Facility: Jacksonville Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $147
Cash Discount Price: $254
vs. Medicare Baseline: 3.19x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Jacksonville Memorial Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.19x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $254 (551%)

Insurance Median: $147 (319%)

Cash: $254 (551% of Medicare)

Ins. Median: $147 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Blue Cross Blue Shield	$36 - $262	78%
Coventry	$39 - $43	85%
Health Alliance	$39 - $178	85%
Humana	$39 - $223	85%
Medicare (plans)	$39 - $43	85%
UnitedHealthcare	$39 - $189	85%
Tricare	$43 - $48	93%
Corvel/Corcare	$48 - $137	104%
Illinois Workers Compensation	$52 - $139	113%
Medicaid / KanCare	$71	154%
Molina Healthcare	$71	154%
Health Alliance Mh Employee Plan	$113 - $121	245%
Commercial Workers Compensation	$124 - $132	269%
Current Health Network	$135 - $196	293%
6 Degrees Health	$147 - $157	319%
Hope Trust	$147 - $157	319%
Hst	$147 - $157	319%
Cigna	$170 - $182	369%
Aetna	$171 - $210	371%
Healthlink	$208 - $223	451%
Phcs/Multiplan	$220 - $236	477%
Hfn	$233 - $249	506%
Liability	$245 - $262	532%

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 $254.
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 Jacksonville Memorial 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.