CMS Price Transparency Data

Orthotic fitting and training

Facility: Mercy Rehabilitation Hospital Springfield

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $118
Cash Discount Price: $118
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercy Rehabilitation Hospital Springfield is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.56x the Medicare baseline. Located in 5904 S Southwood Rd, Springfield, MO.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $118 (256%)

Insurance Median: $118 (256%)

Cash: $118 (256% of Medicare)

Ins. Median: $118 (256% 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 256% of the Medicare baseline (a markup of 156%). 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
Aetna	$71 - $118	154%
Blue Preferred	$86	187%
Firsthealth Network	$86	187%
Blue Cross Blue Shield	$90 - $118	195%
Healthlink Workcomp	$100	217%
Allwell From Home State Health	$118	256%
Allyalign Health (Nhc Advantage)	$118	256%
Ambetter / Centene	$118	256%
Architectural Systems, Inc. (Asi)	$118	256%
Ava R1 School District (Smbc)	$118	256%
Bakersfield School District (Smbc)	$118	256%
Blue Access	$118	256%
Bolivar School (Smbc)	$118	256%
Buchheit	$118	256%
Cardinal Scale (Tri State Healthcare Coalition)	$118	256%
Carthage R-9 School District (Tri-State Healthcare Coalition)	$118	256%
Cigna	$118	256%
City Of Springfield	$118	256%
City Of Webb City (Tri State Healthcare Coalition)	$118	256%
Devoted Healthcare	$118	256%
Diversified Plastics	$118	256%
Dora School District (Smbc)	$118	256%
Easter Seals Midwest	$118	256%
Employers Benefit Alliance	$118	256%
Essence	$118	256%
Evolutions	$118	256%
Fabick Cat	$118	256%
Fair Grove School District (Smbc)	$118	256%
Health Net Federal Services	$118	256%
Health Systems, Inc.	$118	256%
Healthlink Hmo	$118	256%
Healthlink Ppo	$118	256%
Heart Of America (Tri State Healthcare Coalition &Amp;#8211; Med Pay)	$118	256%
Hickory County Skyline School District (Smbc)	$118	256%
Home State Health Plan, Inc.	$118	256%
Humana	$118	256%
J And M Farms, Inc. (Tri-State Healthcare Coalition)	$118	256%
Jayhawk Fine Chemicals/Evonic(Tri State Healthcare Coalition)	$118	256%
Laclede County School District Conway (Smbc)	$118	256%
Lebanon School District (Smbc)	$118	256%
Liberty Utilities (Empire District Electric)	$118	256%
Marshfield School District (Smbc)	$118	256%
Medica	$118	256%
Medicaid / KanCare	$118	256%
Mercy Charity Contract	$118	256%
Mers Goodwill	$118	256%
Missouri State University	$118	256%
Mount Vernon School District (Smbc)	$118	256%
Mountain Grove R-111 School District (Smbc)	$118	256%
Mountain View School District (Smbc)	$118	256%
Multiplan/Phcs/Beech Street	$118	256%
Ozarks Community Hospital	$118	256%
Pathway/Pathway X	$118	256%
Phcs Savility	$118	256%
Quality Collisson Group	$118	256%
Quiktrip Corporation	$118	256%
Richards R-V School District (Smbc)	$118	256%
Roper Automotive Group (Tri State Healthcare Coalition)	$118	256%
S And H Farm Supply	$118	256%
Schreiber Foods	$118	256%
Shinesolar	$118	256%
Springfield Public Schools	$118	256%
Springfield Remanufacturing	$118	256%
Trailiner	$118	256%
UnitedHealthcare	$118	256%
Webb City R-Vii School District (Tri-State Healthcare Coalition)	$118	256%
Wellcare Health Plans	$118	256%
Woodard Cleaning &Amp;#038; Restoration, Inc.	$118	256%

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 $118.
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 Mercy Rehabilitation Hospital Springfield 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.