Orthotic fitting and training
Facility: Greenwood County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $57
- Cash Discount Price: $54
- vs. Medicare Baseline: 1.24x 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 |
|---|---|---|
| Triwest - All Plans | $24 | 52% |
| Tricare | $29 | 63% |
| Choicecare Mcr Adv - All Plans | $29 | 63% |
| UnitedHealthcare | $29 - $57 | 63% |
| Blue Cross Blue Shield | $37 - $39 | 80% |
| Integrated Health Plan - All Plans | $51 | 111% |
| First Health - All Other Plans | $58 | 126% |
| Beech Street - All Plans | $58 | 126% |
| First Health Ccn Network | $58 | 126% |
| Preferred Hs (Coventry) - All Plans | $61 | 132% |
| Principal Health Care Inc - All Plans | $65 | 141% |
| Amerigroup Mcaid-All Plans | $68 | 148% |
| Medicaid / KanCare | $68 | 148% |
| Providrs Care/Wppa - All Plans | $102 | 221% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Greenwood County Hospital in Eureka, Kansas, lists a cash median price of $54.00, which is lower than the facility's negotiated rates of $57.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash payments can sometimes be more cost-effective than using insurance, particularly if your plan has a high deductible or if the insurer's negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the final amount owed.
The data indicates that the cash rate of $54.00 is significantly lower than the Medicare benchmark of $46.09, suggesting a markup relative to the federal cost baseline. Although the provided dataset does not include specific state or county average figures for comparison, the facility's cash rate remains competitive against the range of negotiated rates paid by various payers, which span from $24 to $102. If you receive a bill that exceeds these amounts, you may be subject to balance billing if you are out-of-network, though the No Surprises Act protects you from such charges for emergency care and non-emergency services at in-network facilities. Always request a detailed, itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.