CMS Price Transparency Data

Orthotic fitting and training

Facility: PAM Health Rehabilitation Hospital of Greater Indiana

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $52
Cash Discount Price: $125
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at PAM Health Rehabilitation Hospital of Greater Indiana is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.13x the Medicare baseline. Located in 2101 Broadway St, Clarksville, IN.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $125 (271%)

Insurance Median: $52 (113%)

Cash: $125 (271% of Medicare)

Ins. Median: $52 (113% 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.

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	$25 - $110	54%
Humana	$29 - $43	63%
Blue Cross Blue Shield	$39 - $51	85%
Palm Beach Aco Reach	$42	91%
Caresource	$43 - $51	93%
Ilumed Aco Reach	$43	93%
UnitedHealthcare	$43 - $175	93%
Caresource Indiana	$52	113%
Velocity Provider Ppo Network	$52 - $93	113%
Prime Health Services	$57 - $106	124%
Multiplan/Phcs	$75	163%
America'S Choice Provider	$87	189%
Quik Trip	$93	202%
Usa Managed Care Organization	$93	202%

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 $125.
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 PAM Health Rehabilitation Hospital of Greater Indiana 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.