CMS Price Transparency Data

Orthotic fitting and training

Facility: Essentia Health

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $46
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Essentia Health is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.00x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $86 (187%)
Insurance Median: $46 (100%)
Cash: $86 (187% of Medicare)
Ins. Median: $46 (100% 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
Advocare/Security Health $46 100%
Blue Cross Blue Shield $46 - $77 100%
Freedom Blue Ppo $46 100%
Healthpartners Care Msho / Mcr Adv $46 100%
Imcare Msho Pcc Prime $46 100%
Imcare Msho Ref Req $46 100%
Itasca Med Care $46 100%
Medica Advantage Solutions $46 100%
Medica Msho/Dual Solutions $46 100%
Medica Prime Solution Group $46 100%
Medicare (plans) $46 100%
Nd Va Administration $46 100%
Platinum Blue/Vantage Blue $46 100%
Primewest Msho $46 100%
Secure Blue Msho $46 100%
Ubh Cost Plan $46 100%
Ubh Msho $46 100%
Ucare Msho $46 100%
UnitedHealthcare $46 100%
Primewest $48 104%
Sanford Health Plan $49 - $95 106%
Ucare $75 163%
Wea $82 - $88 178%
America'S Ppo $88 191%
Wps $95 206%
Aetna $97 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals