CMS Price Transparency Data

Orthotic fitting and training

Facility: The Children's Mercy Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $143
Cash Discount Price: $105
vs. Medicare Baseline: 3.10x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at The Children's Mercy Hospital is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.10x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$105

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: $105 (228%)

Insurance Median: $143 (310%)

Cash: $105 (228% 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	$90 - $162	195%
Medicaid / KanCare	$99	215%
Cigna	$105 - $152	228%
Home State Health	$109	236%
UnitedHealthcare	$114 - $147	247%
Healthy Blue	$125	271%
Medica	$128	278%
Aetna	$131 - $149	284%
Centivo	$142	308%
Nebraska Furniture Mart	$142	308%
Orscheln	$142	308%
Wellfit/Centrus	$142	308%
Wppa Providrs Care	$142	308%
Health Midwest Comprehensive Care	$143	310%
Quiktrip	$143	310%
Humana	$146	317%
Coventry Health Care Of Kansas	$162	351%
Coxhealth Network	$162	351%
Mercy Health	$164	356%
Multiplan	$166	360%
American Healthcare Alliance	$186	404%
Healthlink	$193	419%
National Preferred Provider Network	$197	427%

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 $105.
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 The Children's Mercy Hospital 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.