CMS Price Transparency Data

Orthotic fitting and training

Facility: St Francis Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $160
Cash Discount Price: $144
vs. Medicare Baseline: 3.47x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at St Francis Hospital is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.47x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$144

Average discount available for prompt cash payment at this facility.

Insurance Median

$160

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: $144 (312%)

Insurance Median: $160 (347%)

Cash: $144 (312% of Medicare)

Ins. Median: $160 (347% 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 347% of the Medicare baseline (a markup of 247%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$42	91%
Clear Spring Health of Illinois	$42	91%
Blue Cross Blue Shield	$42 - $46	91%
UnitedHealthcare	$44 - $200	95%
Molina Healthcare	$44 - $47	95%
Aetna	$44 - $141	95%
Wexford	$45	98%
Meridian Health Plan	$49	106%
Amish Community	$56	122%
Celtic Insurance Company	$101	219%
Claim Doc	$105	228%
Hopetrust	$115	250%
Wellfirst	$129	280%
First Health	$148	321%
Caterpillar, Inc.	$160	347%
Current Health Solutions	$168	365%
Multiplan/Phcs	$170	369%
Consociate Group	$170	369%
Healthlink	$171	371%
Healthcare Finest Network (Hfn)	$180	391%
Provider Network of America	$180	391%
Healthscope	$200	434%
Interplan	$200	434%
Health Alliance Medical Plans	$200	434%
Illinois Breast and Cervical Cancer Program	$200	434%
Naphcare	$200	434%
Cigna	$200	434%
Live360	$200	434%

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 $144.
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 St Francis Hospital 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.