Orthotic fitting and training
Facility: Wesley Medical Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $60
- Cash Discount Price: $558
- vs. Medicare Baseline: 1.30x 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 |
|---|---|---|
| Aetna | $38 - $200 | 82% |
| Coventry Health Care | $38 - $43 | 82% |
| Humana | $38 - $43 | 82% |
| Devoted Health | $38 - $43 | 82% |
| United | $39 - $251 | 85% |
| Ambetter / Centene | $40 - $100 | 87% |
| Triwest Health Alliance | $43 | 93% |
| Blue Cross Blue Shield | $44 | 95% |
| Correct Care Solutions | $57 - $65 | 124% |
| First Health | $60 - $257 | 130% |
| Multiplan | $62 - $502 | 135% |
| Health Partners Of Kansas | $97 - $279 | 210% |
| Wppa | $97 | 210% |
| Preferred Health Choices | $105 | 228% |
| Medical Associates Health Plan | $105 | 228% |
| Spirit Aerosystems | $179 | 388% |
| Triwest Healthcare Alliance | $363 | 788% |
| Usa Managed Care | $474 | 1028% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, "Orthotic fitting and training," Wesley Medical Center in Wichita, KS, lists a cash price of $558.00, which matches the facility's cash median. This rate is 130% of the Medicare benchmark of $46.09, indicating a markup consistent with commercial pricing structures where negotiated rates often range between 200% and 300% of Medicare. While the facility's cash price is significantly higher than the state average of $60.00 for the median negotiated rate, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds the cash price. It is important to note that commercial rates include administrative overhead for claims processing and contract management, which can inflate the baseline price by 20% to 40% compared to the true cost of care.
Patients should verify their specific insurance plan's negotiated rate before scheduling, as in-network rates vary widely among the 18 payers represented in this data, ranging from $38 to $474. For instance, while some plans like Triwest Health Alliance and Wppa have a fixed allowed amount of $97, others like Multiplan and First Health have much higher ranges extending up to $502 and $257, respectively. To minimize out-of-pocket costs, individuals should ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the costly insurance billing cycle. Additionally, if you have received a bill, request a full itemized statement to review