Orthotic fitting and training
Facility: Cloud County Health Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $224
- Cash Discount Price: $170
- vs. Medicare Baseline: 4.86x 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 486% of the Medicare baseline (a markup of 386%). 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 |
|---|---|---|
| Aetna | $191 - $254 | 414% |
| Health Partners - All Plans | $202 - $260 | 438% |
| Pponext-All Plans | $202 - $260 | 438% |
| Mpi-All Plans | $202 - $260 | 438% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Cloud County Health Center in Concordia, KS, lists a cash median price of $170.00, which is lower than the facility's negotiated rate of $224.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that commercial insurance carriers typically pay negotiated rates that include administrative overhead, often resulting in higher costs for members compared to direct cash payments.
The facility's pricing data reflects a gross charge of $243.00, with specific payer ranges for Aetna ($191–$254) and Health Partners ($202–$260). When compared to the national Medicare benchmark of $46.09, the facility's cash rate represents a markup of 4.9 times the Medicare amount. To ensure you receive the best possible rate, we recommend contacting the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% for upfront payments. Additionally, always request a full itemized bill before paying to verify that no unbundled codes or services not rendered have been included in the final charge.