Orthotic fitting and training
Facility: Satanta District Hospital, Clinics, & Ltcu
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $39
- Cash Discount Price: $49
- 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 |
|---|---|---|
| Direct Benefit-All Plans | $13 | 28% |
| UnitedHealthcare | $16 - $54 | 35% |
| Berkley Net-All Plans | $22 | 48% |
| Trustmark Health Benefits-All Plans | $24 | 52% |
| Meritain Health-All Plans | $24 | 52% |
| Aetna | $24 - $37 | 52% |
| Ambetter / Centene | $26 | 56% |
| Axa Equitable - All Plans | $30 | 65% |
| Pinnacol-All Plans | $30 | 65% |
| Medi-Share-All Plans | $31 | 67% |
| Presbyterian-All Plans | $33 | 72% |
| Kasb Work Comp - All Plans | $35 | 76% |
| The Kempton Group Admin-All Plans | $37 | 80% |
| Auxiant - All Plans | $38 | 82% |
| Wppa- All Plans | $38 | 82% |
| Gpha(Wppa)-All Other Plans | $38 | 82% |
| Providers Care Network- All Plans | $39 | 85% |
| Gpha Employee Benefit Plan | $39 | 85% |
| Emc-All Plans | $39 | 85% |
| Sisco-All Plans | $39 | 85% |
| Regional Care(Wppa)-All Plans | $40 | 87% |
| Employee Benefit-All Plans | $40 | 87% |
| Triangle-All Plans | $41 | 89% |
| First Health -All Plans | $41 | 89% |
| One Call Physician-All Plans | $42 | 91% |
| Christian Hospital Aid - All Plans | $43 | 93% |
| Blue Cross Blue Shield | $43 | 93% |
| Tricare | $43 | 93% |
| Humana | $46 | 100% |
| Cigna | $48 | 104% |
| Luminare Health- All Plans | $48 | 104% |
| Coresource-All Plans | $49 | 106% |
| Deseret Mutual(Uhis)-All Plans | $49 | 106% |
| Vaccn-All Plans | $50 | 108% |
| Reserve National-All Plans | $51 | 111% |
| Wps Vapc-All Plans | $51 | 111% |
| Hma Llc-All Plans | $51 | 111% |
| Medicaid / KanCare | $54 | 117% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the facility's cash median rate is $49.00, which is slightly higher than the state average of $46.09. While commercial insurance plans generally negotiate lower rates than the cash price, the data shows a wide variance in allowed amounts, ranging from $13 to $54 across 38 different payers. For patients with high-deductible plans, paying the cash rate of $49.00 upfront may be more cost-effective than relying on insurance, as some negotiated rates exceed the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these incentives can further reduce the final amount owed.
Patients should be aware that commercial insurance rates often include administrative overhead, which can inflate the baseline price compared to the Medicare benchmark of $46.09. Although the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, it is crucial to request a detailed, itemized bill before paying to ensure no errors or unbundled charges are present. Since over 80% of hospital bills contain errors, verifying the line-by-line statement is the most effective way to avoid unexpected costs. If a discrepancy is found, a formal written dispute should be sent to the billing supervisor rather than settling verbally to protect your rights and ensure accurate reimbursement.