Orthotic fitting and training
Facility: Kansas Medical Center Llc
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $43
- Cash Discount Price: $58
- vs. Medicare Baseline: 0.93x 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 |
|---|---|---|
| Blue Cross Blue Shield | $38 - $43 | 82% |
| Tricare | $39 | 85% |
| Indian Health | $39 | 85% |
| Wppa | $39 | 85% |
| Humana | $43 | 93% |
| Ambetter / Centene | $43 | 93% |
| Medadv_Wellcare | $43 | 93% |
| Aetna | $71 | 154% |
| United | $85 | 184% |
| Three_Rivers | $86 | 187% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Kansas Medical Center Llc in Andover, KS, lists a cash median price of $58.00. This cash rate is notably lower than the facility's negotiated rates, which range from $38 to $86 depending on the insurance carrier. While the facility's cash price is competitive, patients should be aware that commercial insurance plans often negotiate rates higher than cash prices due to administrative costs and contract structures. For individuals with high-deductible plans, paying the cash price of $58.00 upfront may result in lower out-of-pocket costs compared to having an insurance plan pay a negotiated rate that exceeds the cash amount, provided the patient's deductible has been met.
The facility's pricing is benchmarked against the federal Medicare rate of $46.09, with a ratio of 0.9 indicating the cash price is slightly below the Medicare benchmark. It is important to note that this facility is an acute care hospital with a proprietary ownership structure, and while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur for ancillary services. To minimize costs, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. If a large bill is received after insurance processing, consumers should demand a full itemized audit to identify errors, unbundled codes, or services not rendered before agreeing to any payment plan.