Orthotic fitting and training
Facility: Stevens County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $78
- Cash Discount Price: $90
- vs. Medicare Baseline: 1.69x 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 |
|---|---|---|
| Humana | $33 | 72% |
| Aetna | $34 - $90 | 74% |
| Blue Cross Blue Shield | $38 - $40 | 82% |
| First Health - All Plans | $81 | 176% |
| Wppa - All Plans | $85 | 184% |
| Medicaid / KanCare | $90 | 195% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Stevens County Hospital in Hugoton, KS, lists a cash price of $90.00, which matches the facility's negotiated median paid amount of $78.00. This cash rate is significantly higher than the state average of $46.09, which is the Medicare benchmark for this service. While the facility is a Critical Access Hospital with a government-local ownership structure, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates, which range from $33 to $90 depending on the payer. It is important to note that commercial payers like Aetna and Blue Cross Blue Shield have negotiated rates that can exceed the cash price, meaning paying out-of-pocket upfront could result in immediate savings compared to the administrative costs and potential deductibles associated with insurance claims.
Patients should proactively request self-pay or prompt-pay discounts before scheduling any appointments, as these upfront payment incentives can reduce the final bill by 20% to 50%. Although the facility's cash rate is above the state average, the lack of balance billing protections for out-of-network services at in-network facilities means that unexpected charges could arise if ancillary services are not covered. To ensure transparency, consumers should demand a full itemized bill listing specific CPT codes rather than accepting summary invoices, and they should verify their deductible status before relying on insurance to avoid paying the full negotiated amount. Given that over 80% of hospital bills contain errors, requesting a formal written audit dispute for any discrepancies is a critical step in managing medical debt.