CMS Price Transparency Data

Orthotic fitting and training

Facility: Lafayette Regional Health Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $131
Cash Discount Price: $284
vs. Medicare Baseline: 2.84x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Lafayette Regional Health Center is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $284. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.84x the Medicare baseline. Located in 1500 State Street, Lexington, MO.

Cash / Self-Pay

$284

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $284 (616%)

Insurance Median: $131 (284%)

Cash: $284 (616% of Medicare)

Ins. Median: $131 (284% 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 284% of the Medicare baseline (a markup of 184%). 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
Ambetter / Centene	$52 - $54	113%
Nhc Advantage	$53 - $55	115%
Healthyblue	$55 - $58	119%
Corvel Corporation	$62 - $247	135%
Oha Network	$62 - $145	135%
United	$70 - $131	152%
Aetna	$72 - $254	156%
Universal Healthcare	$72 - $76	156%
Humana	$94 - $125	204%
Blue Cross Blue Shield	$105 - $290	228%
College Park Family Care Center	$119 - $125	258%
Oscar	$139 - $145	302%
Cigna	$158 - $207	343%
Wppa Providrs Care Network	$208 - $218	451%
Multiplan	$216 - $226	469%
Coventry	$221 - $232	479%
Coventry Kc Mo	$221 - $232	479%
Cco, Inc.	$236 - $247	512%
Focus Healthcare Mgmt, Inc	$250 - $261	542%

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 $284.
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 Lafayette Regional Health 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.