Orthotic fitting and training
Facility: Johnson Memorial Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $99
- Cash Discount Price: $65
- vs. Medicare Baseline: 2.15x 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 215% of the Medicare baseline (a markup of 115%). 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 |
|---|---|---|
| Connecticut Dept of Correction | $40 | 87% |
| Medicare (plans) | $48 - $50 | 104% |
| Blue Cross Blue Shield | $48 - $119 | 104% |
| UnitedHealthcare | $48 - $369 | 104% |
| Aetna | $48 - $93 | 104% |
| Cigna | $49 - $109 | 106% |
| Cca Senior Care Options | $49 | 106% |
| Fallon Health | $64 | 139% |
| Health New England | $77 | 167% |
| Hap | $93 | 202% |
| Luminare Health | $93 | 202% |
| Gravie Admin Services | $93 | 202% |
| Meritain | $93 | 202% |
| Webtpa | $93 | 202% |
| Nippon Life Ins | $93 | 202% |
| Allied Benefit Systems | $93 | 202% |
| 1199 National Benefit Fund | $93 | 202% |
| Prime Health Services | $95 | 206% |
| Family Life Insurance Company | $99 | 215% |
| Paramount HMO | $99 | 215% |
| Lifetime Benefit Solutions | $99 | 215% |
| Christian Care Ministry | $99 | 215% |
| Manhattan Life | $99 | 215% |
| Ghc Scw | $99 | 215% |
| Trinity Health Share | $99 | 215% |
| Allied National Global Care | $99 | 215% |
| Asrm - Reliance Standard Life Insurance | $99 | 215% |
| PHCS | $99 | 215% |
| Dean Health | $99 | 215% |
| International Benefit Administrators | $99 | 215% |
| Pai | $99 | 215% |
| Mvp | $99 | 215% |
| Pan-American Life | $99 | 215% |
| Multiplan | $99 | 215% |
| Medi Share | $99 | 215% |
| Health Smart | $101 | 219% |
| Diversified Administrators | $103 | 223% |
| Claimdoc | $103 | 223% |
| Innovative Health Plan II | $103 | 223% |
| Magnacare | $109 | 236% |
| Allegiance | $109 | 236% |
| Health Partners | $109 | 236% |
| Centivo | $114 | 247% |
| Bcn Domestic | $119 | 258% |
| Blue Shield - PA (Highmark) | $119 | 258% |
| Blue Shield - Wa (Regence) | $119 | 258% |
| Kaiser Domestic | $119 | 258% |
| Blue Shield - Ny Highmark Western | $119 | 258% |
| Blue Shield - Id (Regence) | $119 | 258% |
| Wc Domestic | $119 | 258% |
| Wellpoint | $119 | 258% |
| Health Choices | $119 | 258% |
| Blue Shield - Ca | $119 | 258% |
| Blue Care Network | $119 | 258% |
| Blue Distinction Transplant | $119 | 258% |
| Blue Benefit Administrators of Massachusetts | $119 | 258% |
| Blue Shield - Ny Highmark Northeastern | $119 | 258% |
| Unicare | $119 | 258% |
| United Behavioral Health Eap | $119 | 258% |
| Pre-Employment | $119 | 258% |
| Connecticare | $242 - $314 | 525% |
| Harvard Pilgrim Healthcare | $369 | 801% |
| Geha | $369 | 801% |