CMS Price Transparency Data

Orthotic fitting and training

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $135
  • Cash Discount Price: $127
  • vs. Medicare Baseline: 2.93x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at University of Wi Hospitals & Clinics Authority is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.93x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$127

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $127 (276%)
Insurance Median: $135 (293%)
Cash: $127 (276% of Medicare)
Ins. Median: $135 (293% 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 293% of the Medicare baseline (a markup of 193%). 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
Medicare (plans) $64 - $148 139%
Alliance_Premier_Network $101 219%
Mercycare $105 228%
Triology $108 - $129 234%
Security_Health_Plan $114 - $135 247%
Employer'S_Coalition_On_Health $117 - $163 254%
Alliance $119 258%
Hfn $121 - $163 263%
United_Healthcare $121 - $180 263%
Beloit_Health_System $123 267%
Aspirus_Health_Plan $124 269%
Cigna $127 276%
Health_Partners_Insurance $129 280%
Health_Payment_Systems $130 282%
UnitedHealthcare $133 289%
Dean_Health_Plan $136 295%
Medical_Associates $140 304%
Wps $147 - $162 319%
Employers_Healthcare_Coalition_Of_Wi $148 321%
Aetna $151 - $170 328%
Blue Cross Blue Shield $152 - $350 330%
Aspirus_Network_Inc $163 354%
Chorus_Community $170 369%
Ghc_Eau_Claire_Health_Plan $170 369%
Multiplan $170 - $195 369%
Sheybogan_Employers_Health_Network $170 369%
Coventry $180 391%
Dean_Care $180 391%
Healthsmart $187 406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals