Orthotic fitting and training
Facility: Stanton County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $110
- Cash Discount Price: $116
- vs. Medicare Baseline: 2.39x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 239% of the Medicare baseline (a markup of 139%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $38 - $110 | 82% |
| Healthy Blue Mcr Adv - All Other Plans | $113 | 245% |
| Healthy Blue Mcaid | $116 | 252% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Stanton County Hospital in Johnson, KS, lists a cash price of $116.00, which matches the facility's negotiated rates with three local payers. This cash price is notably higher than the state average for this service, which is $111.00, and significantly exceeds the Medicare benchmark of $46.09. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that paying cash upfront can sometimes be more cost-effective than using insurance if their plan has a high deductible, as the negotiated rate of $116.00 may exceed the cash price in certain scenarios. It is important to verify your specific plan's allowed amount before scheduling, as commercial rates are often inflated by administrative costs and do not reflect the true cost of care.
To avoid unexpected costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront fee reductions can lower the total bill by 20% to 50%. If you receive a bill after insurance processing, you should request a full itemized audit rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you are out-of-network, the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, so you should dispute any surprise bills immediately rather than paying them out of fear of credit damage. Always ensure you have a written record of any dispute or negotiation to protect your rights.