Orthotic fitting and training
Facility: Clay County Medical Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $73
- Cash Discount Price: $77
- vs. Medicare Baseline: 1.58x 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 | $70 - $73 | 152% |
| Wppa/Providrs Care- All Plans | $70 - $73 | 152% |
| Multiplan- All Plans | $72 - $75 | 156% |
| UnitedHealthcare | $72 - $75 | 156% |
| Health Partners - All Plans | $72 - $75 | 156% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, "Orthotic fitting and training," Clay County Medical Center in Clay Center, KS, lists a cash median price of $77.00, which matches the facility's negotiated median paid rate of $73.00. This cash price is significantly higher than the Medicare benchmark of $46.09, reflecting a markup of 1.6 times the federal rate. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $70 to $75, these amounts remain above the Medicare baseline. For patients with high-deductible plans, paying the cash price of $77.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates exceed the cash amount and could result in out-of-pocket costs once deductibles are met.
To ensure you are receiving the most accurate pricing, it is important to request an itemized billing audit before finalizing payment, as summary bills often obscure individual line items and potential errors. If you choose to pay directly, ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by offering immediate liquidity incentives. Additionally, be aware that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected charges can still occur for out-of-network ancillary services. Always verify your specific plan's deductible status and allowed amounts with the hospital prior to scheduling to avoid unexpected financial burdens.