CMS Price Transparency Data

Orthotic fitting and training

Facility: Fairfield Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $96
Cash Discount Price: $84
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Fairfield Medical Center is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.08x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$84

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $84 (182%)

Insurance Median: $96 (208%)

Cash: $84 (182% of Medicare)

Ins. Median: $96 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Humana	$39 - $177	85%
Aetna	$43 - $122	93%
Blue Cross Blue Shield	$43 - $26,250	93%
Buckeye Community Health	$43 - $83	93%
Medical Mutual	$43 - $33,500	93%
Medicare (plans)	$43	93%
Caresource	$44 - $80	95%
Medigold	$44	95%
Molina	$44 - $79	95%
The Health Plan	$44 - $129	95%
UnitedHealthcare	$44 - $152	95%
Va Ccn	$44	95%
Valor Health Plan	$44	95%
Bwc	$61	132%
Medicaid / KanCare	$79	171%
Oscar	$81	176%
Amerihealth Caritas Ohio	$83	180%
Allied Benefit Systems	$129	280%
Meritain Health	$129	280%
Quality Care Partners/Ohio Ppo Connect	$134	291%
The Ohio State Health Plan	$143	310%
Cigna	$153	332%
Ohio Healthy	$175	380%
Multiplan	$177	384%
Miscellaneous Plans	$186	404%

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 $84.
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 Fairfield Medical Center 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.