Orthotic fitting and training
Facility: Via Christi Hospital Wichita St Teresa, Inc
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $43
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| Va | $43 | 93% |
| Medicare (plans) | $43 - $44 | 93% |
| Vc Hope | $43 | 93% |
| Humana | $43 | 93% |
| Via Christi Research | $43 | 93% |
| Saint Lukes Health Systems | $43 | 93% |
| Blue Cross Blue Shield | $44 | 95% |
| UnitedHealthcare | $44 - $120 | 95% |
| Corizon | $54 | 117% |
| Smarthealth | $60 | 130% |
| Medicaid / KanCare | $73 | 158% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the facility in Wichita, KS, has a median negotiated rate of $43.00 across 11 payers. This rate aligns closely with the state average, as most commercial payers listed, including Va, Vc Hope, and Humana, report a range of $43 to $44. The facility's negotiated rate is also 90% of the Medicare benchmark amount of $46.09, indicating pricing that is competitive relative to the federal baseline. While the facility is a voluntary non-profit church-owned acute care hospital, the data shows no specific cash or median paid values available for this service, suggesting that commercial insurance contracts are the primary pricing mechanism for this procedure.
Patients should be aware that while in-network status protects against balance billing, the negotiated rate of $43.00 may still exceed the cash price if a cash-pay option were available, as commercial contracts often include administrative overhead that inflates the baseline price. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer significant fee reductions for upfront payment by bypassing claims processing costs. Additionally, since the facility is in-network, the No Surprises Act generally prevents unexpected balance billing for emergency or non-emergency services, but patients should verify their deductible status before scheduling to ensure they are not responsible for the full negotiated amount.