CMS Price Transparency Data

Orthotic fitting and training

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $138
Cash Discount Price: $154
vs. Medicare Baseline: 2.99x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.99x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$154

Average discount available for prompt cash payment at this facility.

Insurance Median

$138

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: $154 (334%)

Insurance Median: $138 (299%)

Cash: $154 (334% of Medicare)

Ins. Median: $138 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
The Alliance	$82	178%
Security Health Plan (Shp)	$84 - $94	182%
Amish/Mennonite	$89	193%
Quartz	$92	200%
Wps Health Insurance	$109 - $136	236%
Cigna	$110 - $120	239%
Health Payment Systems	$113	245%
Humana	$128 - $144	278%
Group Health Cooperative Of Eau Claire	$133 - $154	289%
Network Health Plan	$135	293%
First Health	$138	299%
Molina Healthcare Of Wi	$138	299%
Trilogy	$146	317%
Healtheos By Multiplan Inc.	$151 - $154	328%
Health Partners	$154	334%
Coventry	$156	338%
UnitedHealthcare	$253	549%
Blue Cross Blue Shield	$318 - $477	690%

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 $154.
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 - Beaver Dam (Mmc-Bd) 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.