Orthotic fitting and training
Facility: St. Catherine Hospital - Garden City
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $123
- Cash Discount Price: $111
- vs. Medicare Baseline: 2.67x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 267% of the Medicare baseline (a markup of 167%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| UnitedHealthcare | $46 - $232 | 100% |
| Blue Cross Blue Shield | $47 - $205 | 102% |
| Kansas Health | $48 | 104% |
| Kaiser | $48 - $135 | 104% |
| Cigna | $48 - $202 | 104% |
| Devoted Health | $48 | 104% |
| Aetna | $48 - $276 | 104% |
| Innovage | $48 | 104% |
| Humana | $48 | 104% |
| Medicare (plans) | $48 | 104% |
| Denver Health | $54 - $116 | 117% |
| Direct To Employer | $62 - $196 | 135% |
| Centura Employee Plan | $72 | 156% |
| Wpaa | $89 - $230 | 193% |
| Peak Health | $89 - $191 | 193% |
| Christian Health Aid | $102 - $263 | 221% |
| Multiplan | $114 - $416 | 247% |
| Health Partners Of Kansas | $123 - $319 | 267% |
| United Colorado Doctor'S Plan | $143 - $150 | 310% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, St. Catherine Hospital - Garden City lists a gross charge of $279.00. While the facility's cash median rate is $111.00, which is significantly lower than the negotiated rates paid by most insurers, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and network tiering. For instance, the median negotiated rate across payers is $123.00, and individual negotiated rates can reach as high as $416.00 with Multiplan. This dynamic suggests that for patients with high-deductible plans or those who have not yet met their deductible, paying the cash price directly may be more cost-effective than relying on insurance, provided the facility honors self-pay or prompt-pay discounts.
To ensure you are not overcharged, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, it is essential to verify that all ancillary services, such as laboratory tests or emergency physician visits, are covered under your plan's network agreements. When reviewing your specific situation, always compare the facility's rates against the Medicare benchmark of $46.09, which serves as the scientifically validated baseline for healthcare delivery costs, rather than comparing discounts against the inflated hospital chargemaster list.