Orthotic fitting and training
Facility: Clara Barton Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $76
- Cash Discount Price: $59
- vs. Medicare Baseline: 1.65x 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 | $39 | 85% |
| 6 Degrees Health - All Plans | $59 | 128% |
| Wppa-All Plans | $67 | 145% |
| Aetna | $76 | 165% |
| UnitedHealthcare | $76 | 165% |
| Phcs - All Plans | $76 | 165% |
| Hlth Partners Of Ks-All Plans | $77 | 167% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, "Orthotic fitting and training," Clara Barton Hospital in Hoisington, KS, lists a cash median of $59.00, which is lower than the facility's negotiated rate of $76.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance plans often pay significantly more than the cash price due to administrative overhead and contract dynamics. Specifically, the negotiated rates across seven payers range from $39 to $77, with most major carriers like Aetna, UnitedHealthcare, and Phcs settling at $76.00. This suggests that for patients with high-deductible plans, paying the cash price of $59.00 upfront could result in immediate savings compared to the insurance negotiated amount, provided the patient's out-of-pocket costs do not exceed the difference.
When evaluating the cost relative to government benchmarks, the Medicare amount for this service is $46.09. The facility's cash rate of $59.00 represents a markup of approximately 1.6 times the Medicare rate, which aligns with the fair pricing range of 120% to 150% of Medicare, whereas commercial negotiated rates often average between 200% and 300% of this baseline. Given that the facility is located in the 67544 zip code, patients should consider requesting a "prompt-pay" discount, which can reduce the final bill by 20% to 50% if settled in full within 30 days, effectively bypassing the higher administrative costs associated with