Orthotic fitting and training
Facility: Trego County Lemke Memorial Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $55
- Cash Discount Price: $64
- 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 |
|---|---|---|
| Humana | $34 - $39 | 74% |
| Tricare | $37 - $42 | 80% |
| Medicaid / KanCare | $43 - $80 | 93% |
| UnitedHealthcare | $43 - $80 | 93% |
| Aetna | $43 - $72 | 93% |
| Va Ccn - All Plans | $43 - $50 | 93% |
| Ambetter / Centene | $48 - $55 | 104% |
| Blue Cross Blue Shield | $54 | 117% |
| Health Partners - All Plans | $66 - $76 | 143% |
| Healthy Blue Mcaid - All Plans | $70 - $80 | 152% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Trego County Lemke Memorial Hospital lists a cash price of $75.00, which is notably higher than the state average cash median of $64.00. While the facility's negotiated rates with major payers like Humana and Tricare range from $34 to $42, these amounts are still above the state cash median, suggesting that paying out-of-pocket might not always result in the lowest cost for patients with high-deductible plans. It is important to note that commercial insurance contracts often include administrative overheads that can inflate the baseline price by 20% to 40%, meaning the negotiated rate may exceed the cash price despite the facility's government ownership.
Patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. If you receive a bill, always request a full itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, since the facility offers a self-pay classification, you should explicitly ask about prompt-pay discounts before scheduling, as paying in full upfront can often reduce the total cost by 20% to 50% by bypassing costly claims processing.