CMS Price Transparency Data

Orthotic fitting and training

Facility: Marshfield Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $186
Cash Discount Price: $196
vs. Medicare Baseline: 4.04x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Marshfield Medical Center is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.04x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$196

Average discount available for prompt cash payment at this facility.

Insurance Median

$186

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: $196 (425%)

Insurance Median: $186 (404%)

Cash: $196 (425% of Medicare)

Ins. Median: $186 (404% 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 404% of the Medicare baseline (a markup of 304%). 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
Family Health Center (Fhc)	$103	223%
Amish/Mennonite	$113	245%
Sanford Health Plan	$113	245%
Security Health Plan (Shp)	$120 - $177	260%
The Alliance	$143 - $172	310%
Blue Cross Blue Shield	$157 - $181	341%
Group Health Cooperative Of Eau Claire	$169 - $190	367%
Besse Forest Products	$175	380%
Molina Healthcare Of Wi	$175	380%
Rice Lake School District	$175	380%
Wps Health Insurance	$182 - $199	395%
Trilogy	$185 - $198	401%
UnitedHealthcare	$187	406%
Medica Of Wi	$191 - $195	414%
Cigna	$194	421%
Healtheos By Multiplan Inc.	$194 - $196	421%
Corvel	$196	425%
First Health	$196	425%
Health Partners	$196	425%
Three Rivers Provider Network (Trpn)	$196	425%
Coventry	$198	430%
Health Smart	$198	430%
Rising Medical Work Comp	$200	434%

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 $196.
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 Marshfield 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.