Orthotic fitting and training
Facility: William Newton Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $36
- Cash Discount Price: $95
- vs. Medicare Baseline: 0.78x 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 |
|---|---|---|
| Triwest- All Plans | $33 | 72% |
| Ambetter / Centene | $34 - $95 | 74% |
| UnitedHealthcare | $34 - $85 | 74% |
| Blue Cross Blue Shield | $34 - $38 | 74% |
| Providrs Care Nexus | $58 | 126% |
| Providrs Care - All Other Plans | $66 | 143% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the cash price at William Newton Hospital in Winfield, KS, is $95.00. This cash rate aligns exactly with the facility's median paid amount, which is also $95.00. For patients with high-deductible plans, paying this cash price directly can be more cost-effective than using insurance, as the facility's negotiated rates for commercial payers range from $33 to $95, meaning the insurance allowed amount could exceed the cash price. Since this is a Critical Access Hospital, the facility is owned by the local government, and the address is 1300 East Fifth Avenue in Winfield, KS (zip 67156).
When evaluating the cost of this service, it is important to compare the facility's rates against the Medicare benchmark rather than the hospital's gross charges. The Medicare amount for this code is $46.09, and the facility's cash rate of $95.00 represents a markup of 206% relative to the Medicare rate. While commercial negotiated rates for this service vary significantly across payers—ranging from a low of $33 to a high of $95—the cash price remains the most transparent figure for patients. To minimize costs, patients should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, patients should request an itemized bill to ensure no unbundled codes or services not rendered are included, as summary bills often obscure these errors.