CMS Price Transparency Data

Orthotic fitting and training

Facility: Kosciusko Community Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $70
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Kosciusko Community Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.52x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $36 (78%)
Insurance Median: $70 (152%)
Cash: $36 (78% of Medicare)
Ins. Median: $70 (152% 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
Amish Aid $19 - $46 41%
Self Pay $19 - $85 41%
Theramatrix $26 56%
Lutheran Preferred Network $28 - $174 61%
Physicians Health Plan $33 - $100 72%
Php Freedom Network $34 - $84 74%
UnitedHealthcare $35 - $186 76%
Aetna $36 - $115 78%
Encore $36 - $87 78%
Trma Inc $36 - $98 78%
Tricare $41 89%
Blue Cross Blue Shield $43 - $186 93%
Department Of Veterans Affairs $43 93%
Humana $43 - $186 93%
Medicare (plans) $43 93%
Mhs $43 - $186 93%
Veterans Eval Services $43 93%
Iu Health $44 95%
Node Devoted Health Mcr Adv $44 95%
Node Non Par Hospice Agree $44 95%
Node Va $44 95%
One Call Care Diagnostics Wc $44 95%
In Dept Of Correction $46 100%
Node Pphp Mcr Adv $46 100%
Connecticut General Life Insurance Company $52 - $128 113%
Cigna $56 - $137 122%
Lutheran Advanced Network $66 143%
Lutheran Preferred $66 - $88 143%
First Health Network $67 - $163 145%
Prime Health Services $67 - $163 145%
Align In Work Comp $70 152%
One Call Work Comp $70 152%
Us Department Of Labor $70 152%
Advantage Health $74 - $180 161%
Private Healthcare Systems $77 - $187 167%
Sagamore $78 - $204 169%
Encore Work Comp In $79 171%
Encore Health Network $83 - $202 180%
Managed Health Services Exchange $88 191%
Workers Comp $88 191%
Encore Kba Epo $105 228%
Encore Kba Ppo $131 284%
Caresource $143 - $186 310%
Managed Health Services $186 404%
Medicaid / KanCare $186 404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals