CMS Price Transparency Data

Orthotic fitting and training

Facility: Perry County Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $100
Cash Discount Price: $103
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Perry County Memorial Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.17x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $103 (223%)

Insurance Median: $100 (217%)

Cash: $103 (223% of Medicare)

Ins. Median: $100 (217% 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 217% of the Medicare baseline (a markup of 117%). 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
Medicaid / KanCare	$28 - $233	61%
Veterans Administration	$30 - $233	65%
Bc 130	$31 - $186	67%
Group Insurance	$31 - $233	67%
Medicare (plans)	$31 - $61	67%
Workers Compensation	$60 - $116	130%
Nsa	$71 - $144	154%
Guarantor Liable	$85 - $233	184%
Pcmh Insurnace	$94 - $233	204%
Secondary Insurance	$97 - $186	210%
UnitedHealthcare	$97 - $186	210%
Operating Engineers	$103 - $198	223%
Boilermakers Healthcare	$105 - $203	228%
Cigna	$105 - $203	228%
Great West	$105 - $233	228%
Sagxxxx	$105 - $203	228%
Champus	$121 - $233	263%
Ngs American, Inc	$121 - $233	263%
Patoka Valley	$121 - $233	263%
Southwire	$121 - $233	263%
Tricare	$121 - $233	263%
Wausau Benefits	$121 - $233	263%

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 $103.
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 Perry County 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.