Orthotic fitting and training
Facility: Sheridan County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $55
- Cash Discount Price: $88
- vs. Medicare Baseline: 1.19x 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 |
|---|---|---|
| Celtic Insurance | $53 | 115% |
| Blue Cross Blue Shield | $55 | 119% |
| UnitedHealthcare | $84 | 182% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Sheridan County Hospital in Hoxie, KS, lists a cash median price of $88.00. This cash rate is notably higher than the state of Kansas average, which is approximately 120% of the Medicare benchmark of $46.09. While commercial payers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare have negotiated rates of $53, $55, and $84 respectively, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying cash directly can be more cost-effective than relying on insurance, provided the patient's deductible has not yet been met. Patients should verify their specific plan details and inquire about self-pay or prompt-pay discounts before scheduling to ensure they are not paying more than necessary.
It is important to distinguish between the hospital's gross charge of $88.00 and the actual amount paid by insurers, which varies by carrier. The facility, a Critical Access Hospital with government-local ownership, does not provide a median paid amount in this dataset, but the negotiated rates suggest significant variation in commercial pricing. To avoid unexpected costs, consumers should request an itemized bill that breaks down the exact CPT codes and unit costs, rather than accepting a summary invoice that may obscure individual charges. If a balance bill arises from out-of-network ancillary services, the No Surprises Act may offer protections against paying the difference between the chargemaster and the insurance allowed amount, so patients should review their bills carefully and dispute any errors formally in writing.