CMS Price Transparency Data

Orthotic fitting and training

Facility: Sparrow Ionia Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $74
Cash Discount Price: $38
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Sparrow Ionia Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.61x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $38 (82%)

Insurance Median: $74 (161%)

Cash: $38 (82% of Medicare)

Ins. Median: $74 (161% 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	$29 - $84	63%
Covenant Advantage	$29	63%
Medicare (plans)	$29 - $43	63%
Medigold	$29	63%
Senior Community Care	$29	63%
Humana	$30 - $94	65%
Medicaid / KanCare	$30	65%
Blue Care Network	$63	137%
Priority	$71	154%
Blue Cross Blue Shield	$73 - $76	158%
UnitedHealthcare	$89	193%
Cigna	$92	200%
Great West Healthcare	$92	200%
Asr	$93	202%
Health Alliance Plan	$93	202%
Cofinity	$94	204%
Mclaren Commercial	$103	223%

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 $38.
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 Sparrow Ionia 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.