CMS Price Transparency Data

Orthotic fitting and training

Facility: Othello Community Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $128
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 2.78x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Othello Community Hospital is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.78x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$128

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: $120 (260%)
Insurance Median: $128 (278%)
Cash: $120 (260% of Medicare)
Ins. Median: $128 (278% 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 278% of the Medicare baseline (a markup of 178%). 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
Ambetter / Centene $68 - $69 148%
Amerigroup Mcaid $68 148%
Chp Mcaid $68 148%
Cocare - All Plans $68 148%
Gau - All Plans $68 148%
Kaiser - All Plans $68 148%
Molina Mcaid $68 148%
UnitedHealthcare $68 - $160 148%
Chp - All Other Plans $69 150%
Molina - All Other Plans $69 150%
Medicare (plans) $80 174%
Tricare $104 226%
Triwest - All Plans $104 226%
Asuris - All Plans $128 278%
Commercial Other - All Plans $128 278%
Hma - All Plans $128 278%
Hmso - All Plans $128 278%
Tpsc - All Plans $128 278%
Travelers - All Plans $128 278%
Veterans Admin - All Plans $128 278%
Blue Cross Blue Shield $134 291%
Cigna $142 308%
First Choice - All Plans $144 312%
Aetna $150 325%
Chp Mcr Adv $160 347%
Health Alliance Mcr Adv - All Plans $160 347%
Humana $160 347%
Molina Mcare $160 347%
Wellcare Mcr Adv - All Plans $160 347%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 North 14Th Avenue, Othello, WA 99344
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals