Orthotic fitting and training
Facility: Lane County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $49
- Cash Discount Price: $51
- vs. Medicare Baseline: 1.06x 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 | $43 - $50 | 93% |
| UnitedHealthcare | $43 - $53 | 93% |
| Healthy Blue Mcr Adv - All Other Plans | $48 - $53 | 104% |
| Healthy Blue Mcaid | $48 - $53 | 104% |
| Medicaid / KanCare | $48 - $58 | 104% |
| Wppa Providers-All Plans | $72 - $80 | 156% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Lane County Hospital in Dighton, KS, lists a cash price of $51.00, which matches the facility's cash median. This rate is notably higher than the state average for this service, which is $46.09 (Medicare amount). While commercial payers negotiate rates ranging from $43 to $80 depending on the plan, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $51.00. It is important to note that commercial rates often include administrative overhead and contract dynamics that can inflate the baseline price compared to the true cost of care represented by Medicare benchmarks.
Patients should be aware that insurance companies negotiate maximum rates to protect in-network members, but these rates can sometimes be higher than the cash price due to multi-layered billing structures. If you choose to use insurance, be prepared for potential balance billing if you receive care from out-of-network providers, though the No Surprises Act protects you from such surprise bills for emergency and non-emergency services at in-network facilities. To ensure you receive the best possible rate, always ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling your visit, as paying in full upfront can often result in a fee reduction that bypasses costly insurance claims processing.