CMS Price Transparency Data

Orthotic fitting and training

Facility: Unitypoint Health - Meriter

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $75
  • Cash Discount Price: $195
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Unitypoint Health - Meriter is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $195. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.63x the Medicare baseline. Located in 202 S Park St, Madison, WI.
Cash / Self-Pay
$195

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $195 (423%)
Insurance Median: $75 (163%)
Cash: $195 (423% of Medicare)
Ins. Median: $75 (163% 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.

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
Aspirus $24 - $146 52%
Cigna $30 - $73 65%
Security Health Plan $32 - $75 69%
Mercy Care $37 - $81 80%
Blue Cross Blue Shield $44 - $381 95%
Humana $44 - $47 95%
Illinicare $44 95%
Meridiancare $44 - $47 95%
Prevea 360 $44 - $207 95%
UnitedHealthcare $44 - $248 95%
Health Partners Open Network $47 - $89 102%
Wellmark Uph Self-Funded $53 - $381 115%
Quartz $76 165%
Medical Associates Health Plan $88 - $191 191%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 202 S Park St, Madison, WI 53715
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals