CMS Price Transparency Data

Orthotic fitting and training

Facility: Gundersen Lutheran Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $127
Cash Discount Price: $80
vs. Medicare Baseline: 2.76x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Gundersen Lutheran Medical Center is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.76x the Medicare baseline. Located in 1910 South Ave, La Crosse, WI.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $80 (174%)

Insurance Median: $127 (276%)

Cash: $80 (174% of Medicare)

Ins. Median: $127 (276% 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 276% of the Medicare baseline (a markup of 176%). 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
Amerigroup	$15 - $60	33%
Blue Cross Blue Shield	$15 - $486	33%
Group Health Eau Claire	$15 - $191	33%
Group Health Of South Central	$15 - $170	33%
Icare	$15 - $60	33%
Iowa Total Care	$15	33%
Managed Health Service	$15	33%
Molina Health	$15	33%
UnitedHealthcare	$15 - $173	33%
Aetna	$60 - $201	130%
Medical Associates	$60 - $159	130%
Ucare	$60 - $170	130%
Medica	$71 - $162	154%
Dean Health Plan	$89	193%
Quartz	$90	195%
Health Partners	$106 - $187	230%
Midland Choice	$159	345%
Alliance	$166 - $252	360%
Claim Doc Llc	$170	369%
Wps Narrow Network	$172	373%
Cigna	$174	378%
Wps - Arise	$174	378%
Aspirus Arise Health	$176	382%
Allied National General	$180	391%
Preferred One	$180	391%
Wps Statewide	$180	391%
Coventry Health Care	$201	436%
Humana	$201	436%
Multiplan/Healtheos	$204	443%

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 $80.
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 Gundersen Lutheran 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.