CMS Price Transparency Data

Orthotic fitting and training

Facility: Gateway Rehabilitation Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $403
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 8.74x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Gateway Rehabilitation Hospital is $403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 8.74x the Medicare baseline. Located in 5940 Merchants St, Florence, KY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$403

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%)
Insurance Median: $403 (874%)
Ins. Median: $403 (874% 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 874% of the Medicare baseline (a markup of 774%). 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
Devoted Health Plan $403 874%
Cigna $403 874%
UnitedHealthcare $403 874%
Blue Cross Blue Shield $403 874%
Caresource Kentucky $403 874%
Kentucky $403 874%
Molina $403 874%
Humana $403 874%
Aetna $403 874%
Caresource Ohio $403 874%
Wellcare $403 874%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5940 Merchants St, Florence, KY 41042
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL