Orthotic fitting and training
Facility: Saint John Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $45
- Cash Discount Price: $43
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Medicare (plans) | $43 | 93% |
| Cigna | $43 | 93% |
| Tricare | $43 | 93% |
| Midland Care Connection | $43 | 93% |
| Aetna | $43 | 93% |
| UnitedHealthcare | $43 - $60 | 93% |
| Kansas Superior Select | $44 | 95% |
| Healthy Blue | $45 | 98% |
| Celtic | $45 - $157 | 98% |
| Corizon | $60 | 130% |
| Well Path | $60 | 130% |
| Employer Direct Healthcare | $60 | 130% |
| Centurion | $65 | 141% |
| Naphcare | $67 | 145% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, "Orthotic fitting and training," Saint John Hospital in Leavenworth, KS, lists a cash price of $43.00, which matches the lowest negotiated rate found across 14 payers. This cash price is significantly lower than the facility's gross charge of $449.00 and aligns closely with the state average of $43.00. While the Medicare benchmark for this service is $46.09, the cash rate of $43.00 is slightly below the federal baseline, making it a competitive option for patients without insurance. However, because the cash price is lower than the Medicare rate, patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find that paying the full negotiated rate through their insurance is more cost-effective than paying cash, as the insurance allowed amount for some plans ranges up to $60.00.
Patients should be aware that while Saint John Hospital offers a prompt-pay discount for upfront payment, the facility's billing practices suggest that the cash rate is already the lowest available option for this specific procedure. It is important to note that commercial negotiated rates for this service vary widely, ranging from $43.00 to $157.00 depending on the payer, with UnitedHealthcare showing the highest variance. If a patient receives an itemized bill that includes unexpected charges or a summary bill that obscures individual line items, they should request a full itemized audit to identify any errors, unbundled codes, or services not rendered. Furthermore, under the No Surprises Act, patients are protected from balance billing for out