CMS Price Transparency Data

Orthotic fitting and training

Facility: Essentia Health St Mary's Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $63
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Essentia Health St Mary's Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.37x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $75 (163%)
Insurance Median: $63 (137%)
Cash: $75 (163% of Medicare)
Ins. Median: $63 (137% 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.

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
Medica Access $38 82%
Healthpartners Care Pmap $45 98%
Advocare/Security Health $46 100%
Blue Cross Blue Shield $46 - $87 100%
Freedom Blue Ppo $46 100%
Healthpartners Care Msho / Mcr Adv $46 100%
Imcare Msho (Ref Req) $46 100%
Imcare Msho Pcc Prime $46 100%
Imcare Msho Ref Req $46 100%
Itasca Med Care $46 100%
Medica Advantage Solutions $46 100%
Medica Msho/Dual Solutions $46 100%
Medica Prime Solution Group $46 100%
Medicare (plans) $46 100%
Nd Va Administration $46 100%
Platinum Blue / Vantage Blue $46 100%
Primewest Msho $46 100%
Secure Blue Msho $46 100%
Ubh Cost Plan $46 100%
Ubh Msho $46 100%
Ucare Msho $46 100%
UnitedHealthcare $46 - $83 100%
Primewest $48 104%
Sanford Health Plan $49 - $97 106%
Blue Plus Pmap Pcc Prime $50 - $57 108%
Medica $63 - $65 137%
Medica Uplan $63 137%
Healthpartners $68 - $82 148%
Medica Choice $70 152%
Ucare $75 163%
Cigna $82 178%
Healthpartners Pcc Prime $82 178%
Wea $82 - $88 178%
America'S Ppo $88 191%
Security Health $88 191%
Wps $95 - $96 206%
Aetna $97 210%
Healthscope Benefits $97 210%
Healtheos $98 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals