Orthotic fitting and training
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $48
- Cash Discount Price: $54
- vs. Medicare Baseline: 1.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $21 - $43 | 46% |
| Medica Contracted [320239] | $30 | 65% |
| UnitedHealthcare | $40 - $56 | 87% |
| Humana | $41 - $42 | 89% |
| Aetna | $41 - $71 | 89% |
| Tricare | $41 | 89% |
| Kindful Hospice Contracted [320434] | $42 | 91% |
| Kindful Hospice [20434] | $42 | 91% |
| Dept Of Veteran Affairs Contracted [320106] | $42 | 91% |
| Pace Of The Ozarks Contracted [320518] | $42 | 91% |
| Halo Hcr Inc Hospice Contracted [320432] | $42 | 91% |
| Cross Timbers Hospice [20098] | $42 | 91% |
| Blue Cross Blue Shield | $42 - $48 | 91% |
| Halo Hcr Inc Hospice [20432] | $42 | 91% |
| Elara Caring Aspire Hospice [20433] | $42 | 91% |
| Mercy Hospice Okc [20252] | $42 | 91% |
| Medicare (plans) | $42 | 91% |
| Ambetter / Centene | $43 | 93% |
| Home State Health Plan Contracted [320187] | $43 | 93% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $44 | 95% |
| United Medical Resources Contracted [320454] | $56 | 122% |
| Cigna | $57 - $64 | 124% |
| Imagine 360 Contracted [320494] | $66 | 143% |
| Ebms Contracted [320493] | $66 | 143% |
| Healthlink Contracted [320179] | $66 | 143% |
| American Healthcare Alliance Contracted [320020] | $66 | 143% |
| Edison Health Solutions Contracted [320502] | $66 | 143% |
| Yuzu Health Contracted [320521] | $66 | 143% |
| Mercy Benefit Admin Contracted [320251] | $66 | 143% |
| Auxiant Contracted [320462] | $66 | 143% |
| Reflect Health Contracted [320492] | $66 | 143% |
| Aither Health Contracted [320449] | $66 | 143% |
| Workers Comp [20426] | $66 | 143% |
| First Health Contracted [320128] | $71 | 154% |
| Health Choice Contracted [320166] | $72 | 156% |
| Providrs Care Network Contracted [320484] | $82 | 178% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Mercy Hospital Pittsburg, Inc. lists a cash median price of $54.00, which is notably higher than the facility's own negotiated rate of $48.00. While the hospital's negotiated rates range from $21 to $82 across 36 different payers, the cash price sits above the state average of $46.09 and the Medicare benchmark of $46.09. Patients with high-deductible plans or those who have already met their out-of-pocket maximums may find that paying the cash price of $54.00 upfront is more cost-effective than relying on insurance, which often results in higher allowed amounts due to administrative overhead and contract structures. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these incentives can significantly reduce the final bill by bypassing the standard insurance billing cycle.
When using insurance, patients should be aware that the negotiated rates vary widely by carrier, with the lowest allowed amount being $21 for Medicaid/KanCare and the highest reaching $82 for Providrs Care Network. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify the specific allowed amount for your plan before scheduling, as some commercial payers may negotiate rates that exceed the cash price. To ensure you are receiving the best possible rate, request an itemized billing audit prior to payment to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies. By