CMS Price Transparency Data
Orthotic fitting and training
Facility: Mercy Hospital Tishomingo Inc
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $83
- Cash Discount Price: $109
- vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercy Hospital Tishomingo Inc is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.80x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$109
Average discount available for prompt cash payment at this facility.
Insurance Median
$83
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: $109 (236%)
Insurance Median: $83 (180%)
Cash: $109 (236% of Medicare)
Ins. Median: $83 (180% 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 |
|---|---|---|
| Aetna | $41 - $112 | 89% |
| Humana | $41 - $134 | 89% |
| Medicaid / KanCare | $41 - $50 | 89% |
| Ambetter / Centene | $50 | 108% |
| Home State Health Plan Contracted [320187] | $50 | 108% |
| Novasys Contracted [320285] | $50 | 108% |
| Blue Cross Blue Shield | $54 - $81 | 117% |
| Webtpa Contracted [320417] | $71 | 154% |
| Health Choice Contracted [320166] | $72 | 156% |
| Medicare (plans) | $77 - $108 | 167% |
| Cherokee Nation Health Serv Contracted [320066] | $81 | 176% |
| Cross Timbers Hospice [20098] | $81 | 176% |
| Dept Of Veteran Affairs Contracted [320106] | $81 | 176% |
| Elara Caring Aspire Hospice Contracted [320433] | $81 | 176% |
| Elara Caring Aspire Hospice [20433] | $81 | 176% |
| Halo Hcr Inc Hospice Contracted [320432] | $81 | 176% |
| Halo Hcr Inc Hospice [20432] | $81 | 176% |
| Independent Health [20197] | $81 | 176% |
| Indian Health Service Contracted [320198] | $81 | 176% |
| Kindful Hospice Contracted [320434] | $81 | 176% |
| Kindful Hospice [20434] | $81 | 176% |
| Medical Associates Health [20444] | $81 | 176% |
| Mercy Hospice Okc [20252] | $81 | 176% |
| Provider Partners Health Plans Contracted [320450] | $81 | 176% |
| Qual Choice Contracted [320325] | $81 | 176% |
| Tribute Health Plan Mcr Contracted [320338] | $81 | 176% |
| Tricare | $81 | 176% |
| UnitedHealthcare | $81 - $133 | 176% |
| Globalhealth Contracted [320145] | $82 | 178% |
| Cigna | $83 - $126 | 180% |
| Aither Health Contracted [320449] | $101 - $143 | 219% |
| Mercy Benefit Admin Contracted [320251] | $101 - $143 | 219% |
| Quik Trip Contracted [320447] | $101 | 219% |
| Show-Me Health Administrators Contracted [320483] | $101 | 219% |
| Medica Contracted [320239] | $108 | 234% |
| First Health Contracted [320128] | $112 | 243% |
| Osma Health Contracted [320292] | $118 | 256% |
| Benefit Management Contracted [320052] | $126 - $151 | 273% |
| Healthcare Highways Plus Contracted [320175] | $126 | 273% |
| Private Health Care Systems Contracted [320320] | $126 - $134 | 273% |
| United Medical Resources Contracted [320454] | $133 | 289% |
| Multiplan Contracted [320270] | $134 - $151 | 291% |
| Auxiant Contracted [320462] | $143 | 310% |
| Ebms Contracted [320493] | $143 | 310% |
| Healthlink Contracted [320179] | $143 | 310% |
| Imagine 360 Contracted [320494] | $143 | 310% |
| Preferred Community Choice Contracted [320311] | $143 | 310% |
| Reflect Health Contracted [320492] | $143 | 310% |
| Yuzu Health Contracted [320521] | $143 | 310% |