Orthotic fitting and training
Facility: Bob Wilson Memorial Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $83
- Cash Discount Price: $41
- vs. Medicare Baseline: 1.80x 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 |
|---|---|---|
| Humana | $32 | 69% |
| Aetna | $32 - $81 | 69% |
| Medicare (plans) | $32 | 69% |
| Kansas Health | $32 | 69% |
| UnitedHealthcare | $32 - $85 | 69% |
| Blue Cross Blue Shield | $53 | 115% |
| Centura Employee Plan | $72 | 156% |
| Multiplan | $91 - $94 | 197% |
| Health Partners Of Kansas | $95 | 206% |
| Wppa | $96 | 208% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, "Orthotic fitting and training," Bob Wilson Memorial Hospital in Ulysses, KS, lists a cash price of $102.00, which is significantly higher than the cash median of $41.00 reported for this service in the region. While the facility's negotiated rates range from $32 to $96 depending on the payer, the Medicare benchmark of $46.09 serves as a critical baseline for evaluating these costs. Under Medicare benchmarking principles, commercial rates often exceed the true cost of care, with fair pricing typically defined as 120% to 150% of the Medicare rate. In this case, the facility's gross charge of $102.00 represents a substantial markup compared to the federal baseline, highlighting the importance of comparing rates against Medicare rather than the hospital's inflated chargemaster list.
Patients should be aware that while insurance negotiated rates provide a ceiling for in-network billing, they do not always represent the lowest possible cost. For individuals with high-deductible plans, paying the cash price of $102.00 upfront could be more economical if their insurance allowed amount exceeds this figure, though the data indicates the negotiated range extends as low as $32.00. To secure the best financial outcome, consumers are encouraged to verify their specific plan's allowed amount before scheduling and to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in