Orthotic fitting and training
Facility: Mcpherson Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $103
- Cash Discount Price: $100
- vs. Medicare Baseline: 2.23x 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 223% of the Medicare baseline (a markup of 123%). 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 |
|---|---|---|
| Tricare | $38 | 82% |
| Va Ccn - All Plans | $43 | 93% |
| UnitedHealthcare | $43 - $135 | 93% |
| Wellcare Mcr Adv - All Plans | $43 | 93% |
| Blue Cross Blue Shield | $43 | 93% |
| Humana | $43 | 93% |
| Healthy Blue Mcr Adv | $43 | 93% |
| Ambetter / Centene | $50 | 108% |
| Wppa - All Plans | $94 | 204% |
| Medical Associates - All Plans | $101 | 219% |
| Central Plains - All Plans | $101 | 219% |
| Christian Health Aid - All Plans | $108 | 234% |
| Aetna | $111 - $135 | 241% |
| Multiplan - All Plans | $122 | 265% |
| Health Partners - All Plans | $128 | 278% |
| Cigna | $128 | 278% |
| First Health - All Plans | $128 | 278% |
| Medicaid / KanCare | $135 | 293% |
| Health Blue Mcaid - All Other Plans | $138 | 299% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, McPherson Hospital in Kansas charges a gross price of $135.00. While the facility's cash median rate is $100.00 and the median negotiated rate across payers is $103.00, these figures are significantly higher than the Medicare benchmark of $46.09. The facility's pricing is 2.2 times the Medicare amount, which is a common markup structure where commercial rates often exceed the federal baseline due to administrative costs and contract dynamics. It is important for patients to understand that being in-network does not guarantee the lowest possible price, as some commercial payers in this report have negotiated rates as high as $135.00, matching the gross charge, while others have rates as low as $38.00.
Patients should carefully evaluate whether paying cash upfront might be more cost-effective than using insurance, particularly if their plan has a high deductible or if the negotiated rate exceeds the cash price. The data shows a cash median of $100.00, which is lower than the median negotiated amount of $103.00, suggesting that paying directly could save money in many cases. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final bill by 20% to 50% by bypassing insurance billing cycles. Additionally, since over 80% of hospital bills often contain errors, patients should request a detailed, itemized statement to verify that all charges are accurate before agreeing to any payment plan or final