Orthotic fitting and training
Facility: Ellinwood District Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $39
- Cash Discount Price: $47
- vs. Medicare Baseline: 0.85x 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 |
|---|---|---|
| Cigna | $38 | 82% |
| Blue Cross Blue Shield | $38 | 82% |
| Aetna | $38 | 82% |
| UnitedHealthcare | $38 | 82% |
| Humana | $38 | 82% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the facility in Ellinwood, Kansas, has a gross charge of $55.00. The negotiated rates for this service are consistent across all five major payers listed, including Cigna, Blue Cross Blue Shield, Aetna, UnitedHealthcare, and Humana, with each plan paying exactly $38.00. This negotiated amount aligns with the facility's median negotiated rate of $39.00 and is lower than the cash median of $47.00, suggesting that for patients with high-deductible plans, paying the insurance negotiated rate may be more cost-effective than paying cash directly.
When evaluating the cost relative to national standards, the facility's cash price of $47.00 is 80% of the Medicare amount of $46.09, indicating a pricing structure that is competitive when viewed through the lens of Medicare benchmarking. While the data does not provide specific state or county average comparisons for this procedure, the facility is a Critical Access Hospital owned by a Government Hospital District, which often influences pricing transparency and rate structures. Patients are encouraged to verify their specific plan details and ask the hospital about potential "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost.