CMS Price Transparency Data

Orthotic fitting and training

Facility: Gibson General Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $109
Cash Discount Price: $72
vs. Medicare Baseline: 2.36x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Gibson General Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.36x the Medicare baseline. Located in 1808 Sherman Drive, Princeton, IN.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $72 (156%)

Insurance Median: $109 (236%)

Cash: $72 (156% of Medicare)

Ins. Median: $109 (236% 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 236% of the Medicare baseline (a markup of 136%). 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
Aetna	$34 - $106	74%
Alliance Coal	$34	74%
Ambetter / Centene	$44	95%
Blue Cross Blue Shield	$44 - $68	95%
Caresource Just For Me	$44	95%
Medicare (plans)	$44	95%
Meridiancare (Il)	$44	95%
Meridiancomplete (Il)	$44	95%
Mytruadvantage	$44	95%
UnitedHealthcare	$44 - $95	95%
Va Ccn	$44	95%
Caresource In Marketplace	$66	143%
Noncontracted	$70	152%
Self-Pay	$72	156%
Ky Racing Health & Welfare Fund	$73	158%
Encircle/Encore Prime	$102	221%
Chambercare	$109	236%
Deaconess Onecare	$113	245%
Claimdoc	$116	252%
Encircle/Encore Combined	$116	252%
Gibson County Sheriff	$116	252%
Hopetrust	$116	252%
Hstechnology	$116	252%
Cigna	$120	260%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+)	$120	260%
First Health	$122	265%
Healthlink Hmo	$122	265%
Healthlink Ppo	$122	265%
Integrated Health	$122	265%
Principal Health Care	$122	265%

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 $72.
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 Gibson General 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.