CMS Price Transparency Data

Orthotic fitting and training

Facility: Rockcastle County Hospital, Inc.

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $93
  • Cash Discount Price: $109
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Rockcastle County Hospital, Inc. is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.02x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$109

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$46.09

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $46.09 (100%)
Cash / Self-Pay: $109 (236%)
Insurance Median: $93 (202%)
Cash: $109 (236% of Medicare)
Ins. Median: $93 (202% of 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 202% of the Medicare baseline (a markup of 102%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Caresource Mcaid $23 50%
Coventry Mcaid-All Plans $23 50%
Medicaid / KanCare $23 50%
Molina Mcaid $23 50%
UnitedHealthcare $23 - $63 50%
Tricare $32 69%
Passport Hp Hmo - All Plans $33 - $44 72%
Blue Cross Blue Shield $43 - $122 93%
Caresource Mcr Adv-All Other Plans $43 93%
Humana $43 93%
Molina Marketplace - All Other Plans $43 93%
Molina Mcr Adv $43 93%
Signature Mcr Adv-All Plans $43 93%
Wellcare Mcr Adv-All Other Plans $43 93%
Multiplan-All Plans $105 - $139 228%
Prime Health Services-All Plans $105 - $139 228%
Integrated Hp-All Plans $110 - $145 239%
Corvel - All Plans $112 - $147 243%
Center Care-All Plans $118 - $155 256%
Cigna $120 - $158 260%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals