CMS Price Transparency Data

Orthotic fitting and training

Facility: Wooster Community Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $109
  • Cash Discount Price: $136
  • vs. Medicare Baseline: 2.36x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Wooster Community Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.36x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$136

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $136 (295%)
Insurance Median: $109 (236%)
Cash: $136 (295% of Medicare)
Ins. Median: $109 (236% 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 236% of the Medicare baseline (a markup of 136%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Tricare $43 93%
Blue Cross Blue Shield $44 - $125 95%
Buckeye Mcare $44 95%
Caresource Mcr Adv $44 95%
Humana $44 - $128 95%
Med Mutual Of Oh Mcr $44 95%
Molina Mcr $44 95%
Summacare Mcr $44 95%
The Health Plan Mcr Adv $44 95%
UnitedHealthcare $44 - $129 95%
Valor Hp Mcr-All Plans $44 95%
Magnipower-All Plans $57 124%
Caresource Exch - All Other Plans $62 135%
Aultcare/Primecare Mcr Adv $67 145%
Buckeye Mcaid-All Other Plans $74 161%
Caresource Mcaid $74 161%
Molina Marketplace - All Other Plans $74 161%
Molina Mcaid $76 165%
Aetna $78 - $136 169%
Amerihealth Mcaid-All Plans $78 169%
Clarity Health - All Plans $85 184%
Cerco-All Plans $95 206%
Aultcare Wayne County $102 221%
Aultcare/Primetime Exch $102 221%
Rayco-All Plans $102 221%
Christian Health Ministries-All Plans $109 236%
Cigna $109 236%
Health Ohio Network Employer $109 236%
Wayne County-All Plans $109 236%
Healthsmart Accel $113 245%
Summacare Preferred Choice $113 245%
Health Ohio Network Ppo-All Other Plans $116 252%
Healthsmart Complete Ppo-All Other Plans $116 252%
Ohio Health Choice Supp $116 252%
Ohio Health Group Hlthy - All Other Plans $116 252%
Med Mutual Of Oh Exchange $117 254%
Med Mutual Of Oh Supermed $117 254%
Med Mutual Of Oh Trad-All Other Plans $117 254%
Health Plan Of Upper Ohio-All Plans $120 260%
The Health Plan Comm - All Other Plans $120 260%
Ohio Health Group Pref $121 263%
Aultcare/Primetime-All Other Plans $123 267%
Healthsmart Ppo $124 269%
Summacare-All Other Plans $127 276%
Ohio Health Choice-All Other Plans $128 278%
Healthsmart Hpo $129 280%
Osu-All Plans $129 280%
Central Benefits-All Plans $131 284%
First Health-All Plans $131 284%
Flora-All Plans $131 284%
Beech Street-All Plans $132 286%
Phcs-All Plans $132 286%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals