Orthotic fitting and training
Facility: Logan County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $79
- Cash Discount Price: $23
- vs. Medicare Baseline: 1.71x 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 | $40 | 87% |
| Humana | $49 | 106% |
| Health Partners - All Plans | $109 | 236% |
| Medicaid / KanCare | $115 | 250% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Logan County Hospital in Oakley, KS, lists a cash median price of $23.00, which is significantly lower than the negotiated rates of $49.00 to $115.00 charged by major payers like Humana, Blue Cross Blue Shield, and Medicaid/KanCare. This pricing structure highlights a common billing dynamic where cash-pay options can be substantially cheaper than insurance negotiated rates, particularly for patients with high-deductible plans who may face out-of-pocket costs exceeding the cash price. While the facility is a Critical Access Hospital with government-local ownership, patients should verify their specific plan details and ask directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final amount owed.
It is important to understand that the gross charge of $115.00 represents the full list price, whereas the actual amount paid by insurance varies based on contract terms, with Medicaid/KanCare covering the full $115.00 and commercial plans ranging from $40.00 to $109.00. When reviewing your bill, ensure you receive an itemized statement rather than a summary invoice, as hospitals may bundle services or unbundled codes that inflate the total. If you receive a balance bill for the difference between the provider's full charge and your insurance allowed amount, you may be protected under the No Surprises Act for non-emergency services at in-network facilities; in such cases, you should dispute the bill in writing rather than paying immediately to avoid unexpected financial burdens.