Orthotic fitting and training
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $43
- Cash Discount Price: $58
- vs. Medicare Baseline: 0.93x 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.
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 |
|---|---|---|
| UnitedHealthcare | $24 - $120 | 52% |
| Medicaid / KanCare | $25 | 54% |
| Aetna | $25 | 54% |
| Va | $43 | 93% |
| Blue Cross Blue Shield | $43 - $45 | 93% |
| Medicare (plans) | $43 - $44 | 93% |
| Humana | $43 | 93% |
| Providrs Care | $59 | 128% |
| Smarthealth | $60 | 130% |
| Ambetter / Centene | $73 | 158% |
Consumer Guidance & Cost Commentary
For the CPT code 97760, representing orthotic fitting and training, the facility's cash median rate of $58.00 is notably higher than the state of Kansas average of $43.00. While commercial insurance plans like UnitedHealthcare and Aetna have negotiated rates ranging from $24 to $73, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that commercial negotiated rates frequently include administrative overhead and contract dynamics that inflate the baseline price, so comparing these figures to the Medicare benchmark of $46.09 provides a clearer view of the facility's cost structure.
Patients should be aware that while the facility offers a prompt-pay discount for upfront payment, waiting until after receiving an insurance bill may result in losing this incentive. Additionally, although the No Surprises Act protects against balance billing for emergency care and non-emergency services at in-network facilities, patients should still request an itemized billing audit to ensure no unbundled codes or services not rendered have been charged. By verifying the deductible status before scheduling and asking specifically about self-pay or prompt-pay rates prior to check-in, consumers can avoid unexpected costs and ensure they are paying the most accurate, transparent price available.