CMS Price Transparency Data

Orthotic fitting and training

Facility: Breckinridge Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $42
Cash Discount Price: $56
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Breckinridge Memorial Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.91x the Medicare baseline. Located in 1011 Old Highway 60, Hardinsburg, KY.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

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: $56 (122%)

Insurance Median: $42 (91%)

Cash: $56 (122% of Medicare)

Ins. Median: $42 (91% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$19 - $92	41%
Blue Cross Blue Shield	$19 - $122	41%
Wellcare Mcaid - All Other Plans	$19	41%
Tricare	$33 - $40	72%
Molina Mcr Adv - All Plans	$36 - $42	78%
University Health Care - All Other Plans	$36 - $43	78%
Caresource - All Plans	$37 - $44	80%
UnitedHealthcare	$37 - $104	80%
University Health Care Mcr Adv	$37 - $44	80%
Wellcare Mcr Adv	$37 - $44	80%
Ambetter / Centene	$41 - $48	89%
Humana	$77 - $92	167%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $56.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97760.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Breckinridge Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97760.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.