Orthotic fitting and training
Facility: Salina Regional Health Center
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $110
- Cash Discount Price: $117
- vs. Medicare Baseline: 2.39x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 239% of the Medicare baseline (a markup of 139%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Preferred Phsic | $40 - $164 | 87% |
| Blue Cross Blue Shield | $41 - $44 | 89% |
| Preferred Healthcare - All Other Plans | $53 - $221 | 115% |
| Aetna | $59 - $246 | 128% |
| Providers Care (Wppa)-All Plans | $59 - $246 | 128% |
| Multiplan (Mpi)-All Plans | $59 - $246 | 128% |
| Cigna | $59 - $246 | 128% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, Salina Regional Health Center in Salina, KS, lists a gross charge of $167.00. While the facility's cash median rate is $117.00 and the median negotiated rate across payers is $110.00, the facility's rates are 2.4 times higher than the Medicare benchmark of $46.09. This significant markup highlights the difference between the government's cost-based reimbursement and commercial pricing structures. Patients should be aware that while insurance plans like Preferred Phsic, Blue Cross Blue Shield, and Aetna have negotiated rates ranging from $40 to $246 depending on the specific plan, these amounts often exceed the cash price, making out-of-pocket payment a potentially more economical option for those with high-deductible plans.
To minimize costs, consumers should proactively request "self-pay" or "prompt-pay" discounts before scheduling services, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. It is also important to review any itemized billing statements carefully, as summary bills may obscure individual charges or unbundled codes that should be consolidated. Given that the facility is a voluntary non-profit acute care hospital, patients are encouraged to verify their specific plan details with the billing department to ensure they are not inadvertently agreeing to balance billing or signing away rights to dispute out-of-network ancillary services, which could lead to unexpected additional charges beyond the negotiated or cash rates.