Orthotic fitting and training
Facility: Community Memorial Healthcare, Inc.
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $37
- Cash Discount Price: $61
- vs. Medicare Baseline: 0.80x 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 |
|---|---|---|
| Aetna | $28 - $49 | 61% |
| UnitedHealthcare | $35 | 76% |
| Blue Cross Blue Shield | $40 | 87% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Community Memorial Healthcare, Inc. in Marysville, KS, lists a cash price of $61.00, which matches the facility's median paid amount. This cash rate is significantly lower than the state average for this service, offering a potential savings opportunity for patients with high-deductible plans or those without insurance. While the facility's negotiated rates with major payers like Aetna, UnitedHealthcare, and Blue Cross Blue Shield range from $35.00 to $49.00, these amounts often exceed the cash price due to administrative costs and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket may result in a lower total cost than the insurance allowed amount, particularly if the patient has not yet met their annual deductible threshold.
To ensure you are not overcharged, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a bill that appears to include balance billing for out-of-network services at an in-network facility, you may be protected under the No Surprises Act, which bans surprise bills for emergency and non-emergency care. Additionally, ask the billing department about prompt-pay discounts, which can reduce the cash price by 20% to 50% if paid in full upfront, bypassing the costly insurance claims cycle. Always dispute any unexpected charges in writing rather than accepting summary bills, and confirm that your payment is classified as self-pay to secure the lowest possible rate.