CMS Price Transparency Data

Orthotic fitting and training

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $142
  • Cash Discount Price: $167
  • vs. Medicare Baseline: 3.08x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Rehabilitation Hospital of Wisconsin is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.08x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$167

Average discount available for prompt cash payment at this facility.

Insurance Median
$142

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: $167 (362%)
Insurance Median: $142 (308%)
Cash: $167 (362% of Medicare)
Ins. Median: $142 (308% 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 308% of the Medicare baseline (a markup of 208%). 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
Alliance Ppo $98 - $133 213%
Dean Ppo Hmo/Pos $98 - $133 213%
Medica (Under Dean) $98 - $133 213%
UnitedHealthcare $99 - $192 215%
Trilogy Ppo $102 - $192 221%
Wps "Insurance" Ppo $104 - $141 226%
Phcs Savility $107 - $144 232%
Hps Solutions Ppo $108 - $146 234%
Aetna $111 - $192 241%
Health Eos Poc $114 - $154 247%
Coventry/First Health Ppo $116 - $158 252%
Hps (Other) $116 - $158 252%
Health Eos Multiplan $121 - $164 263%
Phcs / Multiplan $131 - $177 284%
All Savers $142 - $192 308%
Blue Cross Blue Shield $142 - $192 308%
Centivo Broad $142 - $192 308%
Centivo Intermediate/Median $142 - $192 308%
Centivo Narrow/Value $142 - $192 308%
Children'S Communty Health Plan(Cchp) $142 - $192 308%
Cigna $142 - $192 308%
Community Care, Inc $142 - $192 308%
Humana $142 - $192 308%
Icare Mcd $142 - $192 308%
Managed Health Services (Mhs) $142 - $192 308%
Medicaid / KanCare $142 - $192 308%
Medicare (plans) $142 - $192 308%
Molina (Fka Care Wisconsin) $142 - $192 308%
Network Health - Aca $142 - $192 308%
Network Health - Commercial $142 - $192 308%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $142 - $192 308%
Security Health Plan - Advocare $142 - $192 308%
Together With Cchp $142 - $192 308%
Unity Health Plan And Unity Quartz(Hmo/Pos) $142 - $192 308%
Va - Primary Only - Authorization Required $142 - $192 308%
Wellcare Mcr $142 - $192 308%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL