CMS Price Transparency Data

Orthotic fitting and training

Facility: Dekalb Community Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $43
  • Cash Discount Price: $54
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Dekalb Community Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.93x the Medicare baseline. Located in 520 W Main St, Smithville, TN.
Cash / Self-Pay
$54

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $54 (117%)
Insurance Median: $43 (93%)
Cash: $54 (117% of Medicare)
Ins. Median: $43 (93% 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
Blue Cross Blue Shield $25 - $83 54%
Point Comfort Underwriters $38 82%
Community Plan $42 91%
Amerigroup Mcr Replacement $43 93%
Ascension Complete $43 93%
Centurion Of Tn $43 93%
Covid Uninsured Test Fund $43 93%
Healthspring Mcr Replacement $43 93%
Humana $43 93%
Medicare (plans) $43 93%
Nhc Advantage $43 93%
UnitedHealthcare $43 93%
Aetna $44 95%
Ambetter / Centene $56 122%
Oscar Health $60 130%
Smart Health $60 130%
Cigna $61 - $66 132%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 520 W Main St, Smithville, TN 37166
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals