Orthotic fitting and training
Facility: Centura St. Catherine-Dodge City
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $102
- Cash Discount Price: $91
- vs. Medicare Baseline: 2.21x 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 221% of the Medicare baseline (a markup of 121%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $47 - $48 | 102% |
| Humana | $48 | 104% |
| Cigna | $48 | 104% |
| Kansas Health | $48 | 104% |
| Kaiser | $48 | 104% |
| Medicare (plans) | $48 | 104% |
| Aetna | $48 - $263 | 104% |
| Centura Employee Plan | $72 | 156% |
| UnitedHealthcare | $83 - $216 | 180% |
| Wpaa | $89 - $230 | 193% |
| Christian Health Aid | $102 - $263 | 221% |
| Multiplan | $102 - $296 | 221% |
| Health Partners Of Kansas | $114 - $296 | 247% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the facility's cash median price is $91.00, which is significantly lower than the state average of $102.00. While many commercial payers negotiate rates ranging from $48 to $296, the cash price often provides a more affordable option for patients with high-deductible plans or those without insurance, as it bypasses the administrative overhead and markup inherent in negotiated contracts. It is important to note that while the facility is an in-network location for most major insurers, the negotiated rates can sometimes exceed the cash price; therefore, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the most favorable rate available.
The facility's pricing is also contextualized by the Medicare benchmark, which stands at $46.09 for this service. Commercial negotiated rates generally average 200% to 300% of the Medicare rate, though fair pricing is typically defined as 120% to 150% of this baseline. For this specific code, the cash price of $91.00 represents a markup of approximately 2.2 times the Medicare amount, which falls within the range of typical commercial pricing dynamics. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized statement to verify that all charges are accurate and that no unbundled codes or services not rendered have been included. If a balance bill arises from an out-of-network provider at this facility, patients should be aware of federal protections under the No Surprises Act that may