Orthotic fitting and training
Facility: Pratt Regional Medical Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $90
- Cash Discount Price: $71
- vs. Medicare Baseline: 1.95x 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 |
|---|---|---|
| Celtic Insurance Company | $45 | 98% |
| Healthy Blue | $46 | 100% |
| UnitedHealthcare | $49 - $139 | 106% |
| Christian Health Aid | $68 - $102 | 148% |
| Health Partners Of Kansas | $77 - $116 | 167% |
| Aetna | $81 - $122 | 176% |
| Choicecare | $90 - $136 | 195% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, "Orthotic fitting and training," Pratt Regional Medical Center in Pratt, KS, lists a cash median price of $71.00, which is significantly lower than the facility's gross charge of $101.00. While commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $49 to $136, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $71.00. It is important to note that the facility's cash rate is notably higher than the state of Kansas average, suggesting that while the cash option is available, it may not be the lowest cost option compared to regional competitors.
The facility's negotiated rates vary widely across seven payers, with the lowest allowed amount being $45.00 from Celtic Insurance Company and the highest reaching $136.00 from Choicecare. This variation highlights that "in-network" status does not guarantee a uniform price, as different insurers have distinct contract terms. Additionally, the facility offers a cash median of $71.00, which is 53% higher than the Medicare benchmark of $46.09, reflecting the typical markup seen in commercial pricing. Patients are encouraged to request a prompt-pay discount, which can reduce the final bill by 20% to 50% if paid upfront, and to always verify self-pay rates before scheduling to avoid unexpected costs.