CMS Price Transparency Data

Orthotic fitting and training

Facility: Sanford Wheaton Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $143
Cash Discount Price: $131
vs. Medicare Baseline: 3.10x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Sanford Wheaton Medical Center is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.10x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $131 (284%)

Insurance Median: $143 (310%)

Cash: $131 (284% of Medicare)

Ins. Median: $143 (310% 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 310% of the Medicare baseline (a markup of 210%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$40 - $152	87%
Sanford Health Plan Align	$83	180%
Ucare	$89 - $144	193%
Aetna	$90 - $143	195%
Health Partners	$90 - $133	195%
Medicare (plans)	$90	195%
Security Health Plan	$90	195%
UnitedHealthcare	$90 - $137	195%
Primewest	$91 - $99	197%
Sanford Health Plan	$129 - $152	280%
Medica	$144 - $155	312%
First Choice Health Network	$148	321%
Healthez	$148	321%
Multiplan	$148	321%

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 $131.
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 Sanford Wheaton Medical Center 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.