CMS Price Transparency Data

Orthotic fitting and training

Facility: Lincoln Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $99
Cash Discount Price: $111
vs. Medicare Baseline: 2.15x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Lincoln Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.15x the Medicare baseline. Located in 10 Nichols Street, Davenport, WA.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $111 (241%)

Insurance Median: $99 (215%)

Cash: $111 (241% of Medicare)

Ins. Median: $99 (215% 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 215% of the Medicare baseline (a markup of 115%). 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
Ambetter / Centene	$58	126%
Molina Hlthy Options	$58	126%
UnitedHealthcare	$58 - $109	126%
Amerigroup Mcaid - All Plans	$61	132%
Aetna	$69 - $117	150%
Indian Hlth Services - All Plans	$69	150%
Tricare	$69	150%
Va Ccn - All Plans	$69	150%
Labor & Industries - All Plans	$88	191%
Cigna	$94	204%
Molina Exchange-All Other Plans	$98	213%
Focus Healthcare Mgmt - All Plans	$99	215%
Blue Cross Blue Shield	$109	236%
Uniform Medical Plan-All Plans	$109	236%
First Health Coventry-All Plans	$110	239%
Health Management Network-All Plans	$111	241%
Three Rivers-All Plans	$111	241%
Asuris Nw Health-All Plans	$114	247%
Multiplan-All Plans	$117	254%
Physician Hosp Comm Org-All Plans	$117	254%
First Choice Health- All Plans	$120	260%

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 $111.
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 Lincoln Hospital 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.