CMS Price Transparency Data

Orthotic fitting and training

Facility: Upland Hills Health

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $90
Cash Discount Price: $152
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Upland Hills Health is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.95x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $152 (330%)

Insurance Median: $90 (195%)

Cash: $152 (330% of Medicare)

Ins. Median: $90 (195% 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.

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
UnitedHealthcare	$45 - $54	98%
Ghc Of Eau Claire	$47	102%
Ghc Of Sc Wi	$47 - $191	102%
Mhs	$47 - $79	102%
Quartz	$63	137%
Blue Cross Blue Shield	$79 - $230	171%
Humana	$79 - $253	171%
Icare	$79	171%
Medical Associates	$79 - $90	171%
Security Health Plan	$79	171%
Dean Health Plan	$135	293%
Alliance	$159	345%
Wps	$171 - $176	371%
Cigna	$209 - $234	453%
Multiplan	$247	536%

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 $152.
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 Upland Hills Health 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.