CMS Price Transparency Data

Orthotic fitting and training

Facility: Essentia Health Ada

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $55
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Essentia Health Ada is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.19x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $84 (182%)
Insurance Median: $55 (119%)
Cash: $84 (182% of Medicare)
Ins. Median: $55 (119% 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
Healthpartners Care Pmap $44 95%
Medica Access $45 98%
Itasca Med Care $46 100%
Primewest $48 104%
Sanford Health Plan $49 - $51 106%
Advocare/Security Health $55 119%
Blue Cross Blue Shield $55 - $99 119%
Freedom Blue Ppo $55 119%
Healthpartners Care Msho / Mcr Adv $55 119%
Imcare Msho Pcc Prime $55 119%
Imcare Msho Ref Req $55 119%
Medica Advantage Solutions $55 119%
Medica Msho/Dual Solutions $55 119%
Medica Prime Solution Group $55 119%
Medicare (plans) $55 119%
Nd Va Administration $55 119%
Platinum Blue/Vantage Blue $55 119%
Primewest Msho $55 119%
Secure Blue Msho $55 119%
Ubh Cost Plan $55 119%
Ubh Msho $55 119%
Ucare Msho $55 119%
UnitedHealthcare $55 - $103 119%
Healthpartners $69 - $76 150%
Ucare $75 163%
Cigna $76 165%
Healthpartners Pcc Prime $76 165%
Wea $82 - $88 178%
America'S Ppo $88 191%
Medica $95 - $100 206%
Medica Uplan $95 206%
Wps $96 208%
Aetna $97 210%
Blue Plus Pmap Pcc Prime $99 215%
Medica Choice $103 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 9Th Street West, Ada, MN 56510
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals