CMS Price Transparency Data
Orthotic fitting and training
Facility: Mercy Hospital Carthage
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $89
- Cash Discount Price: $89
- vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercy Hospital Carthage is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.93x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$89
Average discount available for prompt cash payment at this facility.
Insurance Median
$89
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: $89 (193%)
Insurance Median: $89 (193%)
Cash: $89 (193% of Medicare)
Ins. Median: $89 (193% 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 |
|---|---|---|
| Medicaid / KanCare | $34 - $75 | 74% |
| Aetna | $38 - $122 | 82% |
| Blue Cross Blue Shield | $38 - $185 | 82% |
| Cherokee Nation Health Serv Contracted [320066] | $38 | 82% |
| Cigna | $38 - $123 | 82% |
| Cross Timbers Hospice [20098] | $38 | 82% |
| Dept Of Veteran Affairs Contracted [320106] | $38 | 82% |
| Elara Caring Aspire Hospice [20433] | $38 | 82% |
| Globalhealth Contracted [320145] | $38 | 82% |
| Halo Hcr Inc Hospice Contracted [320432] | $38 | 82% |
| Halo Hcr Inc Hospice [20432] | $38 | 82% |
| Humana | $38 - $41 | 82% |
| Indian Health Service Contracted [320198] | $38 | 82% |
| Kindful Hospice Contracted [320434] | $38 | 82% |
| Kindful Hospice [20434] | $38 | 82% |
| Medical Associates Health Contracted [320444] | $38 | 82% |
| Medicare (plans) | $38 - $43 | 82% |
| Mercy Hospice Okc [20252] | $38 | 82% |
| Mercy Mgd Behavioral Health Contracted [320259] | $38 | 82% |
| Pace Of The Ozarks Contracted [320518] | $38 | 82% |
| Provider Partners Health Plans Contracted [320450] | $38 | 82% |
| Qual Choice Contracted [320325] | $38 | 82% |
| Tricare | $38 | 82% |
| UnitedHealthcare | $38 - $119 | 82% |
| Point C Contracted [320238] | $48 - $123 | 104% |
| Health Systems Inc Contracted [320174] | $59 | 128% |
| Insurance System Inc Contracted [320465] | $59 | 128% |
| Administrative Payor Contracted [320005] | $62 | 135% |
| Centivo Contracted [320505] | $63 | 137% |
| Healthscope Contracted [320182] | $71 | 154% |
| Ambetter / Centene | $75 | 163% |
| Home State Health Plan Contracted [320187] | $75 | 163% |
| Novasys Contracted [320285] | $75 | 163% |
| Benefit Management Contracted [320052] | $82 - $119 | 178% |
| Auxiant Contracted [320462] | $89 - $116 | 193% |
| Healthlink Contracted [320179] | $89 - $127 | 193% |
| Preferred Health Plan Contracted [320522] | $89 | 193% |
| Workers Comp [20426] | $110 - $137 | 239% |
| United Medical Resources Contracted [320454] | $114 - $123 | 247% |
| 90 Degree Benefits Contracted [320436] | $116 | 252% |
| Aither Health Contracted [320449] | $116 | 252% |
| Ebms Contracted [320493] | $116 | 252% |
| Edison Health Solutions Contracted [320502] | $116 | 252% |
| Imagine 360 Contracted [320494] | $116 | 252% |
| Mercy Benefit Admin Contracted [320251] | $116 - $123 | 252% |
| Reflect Health Contracted [320492] | $116 | 252% |
| Show-Me Health Administrators Contracted [320483] | $116 | 252% |
| Yuzu Health Contracted [320521] | $116 | 252% |
| Evolutions Health Care Contracted [320124] | $119 | 258% |
| First Health Contracted [320128] | $119 | 258% |
| Medica Contracted [320239] | $119 | 258% |
| Multiplan Contracted [320270] | $119 | 258% |
| Private Health Care Systems Contracted [320320] | $119 | 258% |
| American Healthcare Alliance Contracted [320020] | $123 | 267% |
| Ppo Plus Contracted [320310] | $123 | 267% |
| Usa Managed Care Org Contracted [320429] | $123 | 267% |