Orthotic fitting and training
Facility: Ashland Health Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $55
- Cash Discount Price: $44
- vs. Medicare Baseline: 1.19x 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 | $18 | 39% |
| Compalliance-All Plans | $44 | 95% |
| Health Partners Of Kansas-All Plans | $47 | 102% |
| Multiplan-All Plans | $54 | 117% |
| Healthy Blue Mcr Adv - All Other Plans | $55 | 119% |
| Aetna | $55 | 119% |
| UnitedHealthcare | $55 | 119% |
| Medicaid / KanCare | $55 | 119% |
| Health Choice-All Plans | $55 | 119% |
| Medicare (plans) | $55 | 119% |
| Medica Mcare - All Plans | $55 | 119% |
| Providers Care (Wppa)-All Plans | $82 | 178% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the facility's negotiated rate of $55.00 aligns exactly with the median paid amount and the median negotiated rate across all payers. This rate is 1.2 times the Medicare benchmark of $46.09, indicating the facility's pricing is consistent with the commercial average for this service. While the cash price is listed at $44.00, which is lower than the negotiated rate, patients should be aware that paying cash upfront may not always result in the lowest out-of-pocket cost if their insurance plan has a high deductible or if the negotiated rate exceeds their personal cash price. It is advisable to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available before scheduling, as these incentives can further reduce the final bill by bypassing administrative claim processing fees.
The facility, Ashland Health Center, is a Critical Access Hospital located in Ashland, KS, and its pricing for this service reflects standard commercial rates without significant deviation from the broader market. Since the negotiated rate of $55.00 matches the median across all 12 payers, including Medicaid/KanCare and Medicare, there is no indication of unusually high or low pricing relative to the state or county averages. Patients should avoid assuming that being in-network guarantees the best price, as different insurers may have varying contract terms. To ensure transparency, consumers should request a detailed, itemized bill that breaks down every CPT code and charge, allowing them to verify that no services were unbundled or double-billed before finalizing payment.