CMS Price Transparency Data

Orthotic fitting and training

Facility: Wayne General Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $63
Cash Discount Price: $90
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Wayne General Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.37x the Medicare baseline. Located in 950 Matthew Dr, Waynesboro, MS.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $90 (195%)

Insurance Median: $63 (137%)

Cash: $90 (195% of Medicare)

Ins. Median: $63 (137% 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.

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
Ml Healthcare-All Plans	$36	78%
Humana	$38	82%
Al Healthcare Adv Mcaid-All Plans	$41	89%
Alabama Community Mcaid-All Plans	$41	89%
Medicaid / KanCare	$41	89%
Univita Healthcare Mcaid-All Plans	$41	89%
Amerigroup Mcare Adv-All Plans	$42	91%
Cigna	$42 - $63	91%
Magnolia Mcare Adv	$42	91%
Molina Mcare Adv	$42	91%
Vantage Health Mcare Adv	$42	91%
Wellcare Mcare Adv-All Plans	$42	91%
Molina Chip-All Other Plans	$45	98%
Ahs-All Plans	$63	137%
Phcs-All Plans	$68	148%
Mhci/Healthlink Op Only-All Plans	$76	165%
Ms Health Partners-All Plans	$76	165%
Ppoplus-All Plans	$76	165%
First Choice-All Other Plans	$81	176%
First Health-All Plans	$81	176%
Geha Ppo-All Plans	$81	176%
Healthcare Advantage-All Plans	$81	176%
United Providers-All Plans	$81	176%
Three Rivers Provider Network-All Plans	$86	187%
Aetna	$90	195%
Magnolia Comm/Exchange-All Other Plans	$90	195%
Vantage Health-All Other Plans	$97	210%
First Choice Hie	$112	243%
Blue Cross Blue Shield	$168	365%

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 $90.
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 Wayne General 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.