Orthotic fitting and training
Facility: Goodland Regional Medical Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $102
- Cash Discount Price: $102
- vs. Medicare Baseline: 2.21x 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 221% of the Medicare baseline (a markup of 121%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $40 | 87% |
| Wppa | $96 - $102 | 208% |
| UnitedHealthcare | $102 | 221% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the Goodland Regional Medical Center in Goodland, KS, lists a cash median price of $102.00, which is notably higher than the state average of $102.00. While the facility's negotiated rates with payers like Wppa and UnitedHealthcare range from $96 to $102, these amounts are significantly higher than the Medicare benchmark of $46.09. Under Medicare benchmarking principles, commercial rates often average 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150%. In this case, the cash price of $102.00 represents approximately 221% of the Medicare amount, suggesting that for patients with high-deductible plans, paying cash directly might be more cost-effective than relying on insurance, provided the negotiated rate exceeds the cash price.
Patients should be aware that insurance negotiated rates can sometimes exceed cash prices due to administrative overhead and contract dynamics, meaning an in-network visit does not guarantee the lowest possible cost. To minimize out-of-pocket expenses, it is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Additionally, since over 80% of hospital bills contain errors, consumers should request a full itemized billing audit before making any payments to ensure no unbundled codes or services not rendered are included. Given the facility's status as a Critical Access Hospital with government-local ownership, verifying the specific