Orthotic fitting and training
Facility: Hospital District #6 Patterson Health Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $60
- Cash Discount Price: $54
- vs. Medicare Baseline: 1.30x 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 | $37 - $39 | 80% |
| UnitedHealthcare | $60 - $67 | 130% |
| Providers Care (Wppa)-All Plans | $117 | 254% |
Consumer Guidance & Cost Commentary
For the CPT code 97760 (Orthotic fitting and training) at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median rate of $54.00 is lower than the state average, which is reflected in the cash median of $54.00 provided in the data. While the facility's negotiated rates with major payers like Blue Cross Blue Shield ($37–$39) and UnitedHealthcare ($60–$67) are higher than the cash price, patients with high-deductible plans may find the cash rate more cost-effective if their insurance allowed amount exceeds $54.00. It is important to note that the facility's median negotiated rate of $60.00 aligns with the median paid amount, suggesting consistent billing practices across these plans, though the gross charge of $67.00 represents the full list price before any discounts.
The facility's pricing is benchmarked against Medicare, which sets a baseline of $46.09 for this service. The commercial cash rate of $54.00 is approximately 1.3 times the Medicare amount, indicating a markup that is generally within the range of fair pricing (120% to 150% of Medicare) rather than the higher commercial averages often seen. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still advisable to request a self-pay or prompt-pay discount before scheduling, as these upfront payments can bypass administrative fees and reduce the final cost. To ensure accuracy, consumers should always request an itemized bill to verify that no unb