Orthotic fitting and training
Facility: Phillips County Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $51
- Cash Discount Price: $50
- vs. Medicare Baseline: 1.11x 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 | $40 - $55 | 87% |
| UnitedHealthcare | $40 - $68 | 87% |
| Health Partners-All Plans | $50 - $68 | 108% |
| Medicaid / KanCare | $50 - $68 | 108% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training at Phillips County Hospital in Phillipsburg, Kansas, the cash median price is $50.00, which is lower than the facility's negotiated rates of $51.00 to $52.00. This aligns with the broader principle that cash-pay options can sometimes be more economical for patients with high-deductible plans, as the insurance negotiated rates often exceed the cash price. While the facility is a Critical Access Hospital with government-local ownership, patients should verify their specific plan details, as Blue Cross Blue Shield, UnitedHealthcare, Health Partners-All Plans, and Medicaid/KanCare have negotiated ranges between $40 and $68. It is important to remember that commercial rates often include administrative overhead, making the cash price a strong baseline for comparison.
Before scheduling, patients should proactively request a "self-pay" or "prompt-pay" discount to potentially lower their out-of-pocket costs, as hospitals often offer fee reductions for upfront payment to bypass costly claims processing. If you choose to use insurance, be aware that balance billing is generally prohibited for in-network services at this facility under the No Surprises Act, though unexpected charges can still occur with out-of-network ancillary services. To ensure accuracy, always demand a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Finally, compare all rates against the Medicare benchmark of $46.09; since fair pricing is typically defined as 120% to 150% of this amount, the facility's rates fall within a