Orthotic fitting and training
Facility: Graham County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $37
- Cash Discount Price: $42
- vs. Medicare Baseline: 0.80x 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 |
|---|---|---|
| Medicare (plans) | $32 | 69% |
| UnitedHealthcare | $34 - $40 | 74% |
| Celtic Commercial-All Other Plans | $35 | 76% |
| Blue Cross Blue Shield | $39 | 85% |
| Wppa (Providers Care)-All Plans | $40 | 87% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, "Orthotic fitting and training," Graham County Hospital in Hill City, KS, lists a cash price of $42.00. This cash rate matches the facility's median paid amount and is identical to the Medicare benchmark of $46.09, which serves as a reliable baseline for fair pricing. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial negotiated rates for this service range from $32 to $40 across five payers, including UnitedHealthcare and Blue Cross Blue Shield. In this specific case, the cash price is competitive, but patients with high-deductible plans might find the cash rate more affordable if their insurance negotiated rate exceeds $42.00, as paying out-of-pocket could result in immediate savings compared to waiting for insurance reimbursement.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a surprise bill, remember that the No Surprises Act generally protects you from balance billing for out-of-network services at in-network facilities, and you should dispute any unexpected charges in writing rather than paying immediately out of fear. Additionally, since the facility offers a cash price of $42.00, you should explicitly ask about "self-pay" or "prompt-pay" discounts at the time of scheduling, as hospitals often provide significant fee reductions for upfront payments that bypass the costly insurance claims process.