CMS Price Transparency Data

Orthotic fitting and training

Facility: Grandview Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $186
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 4.04x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Grandview Medical Center is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.04x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$186

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: $68 (148%)
Insurance Median: $186 (404%)
Cash: $68 (148% of Medicare)
Ins. Median: $186 (404% 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 404% of the Medicare baseline (a markup of 304%). 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
Medicaid / KanCare $18 39%
Tricare $40 87%
Blue Advantage $42 91%
Cigna $42 - $171 91%
Hospice $42 91%
Humana $42 91%
Medicare (plans) $42 91%
Node Champva $42 91%
Node Devoted Health Mcr Adv $42 91%
Node Va $42 91%
Select Health $42 91%
UnitedHealthcare $42 - $217 91%
Veterans Eval Services $42 91%
Victory Health $42 91%
Viva Health $42 - $191 91%
Aetna $43 93%
Node Clover Health Mcr Adv $43 93%
Node Wellcare Mcr Adv $43 93%
Alamed $45 98%
Self Pay $50 - $90 108%
First Health $52 - $224 113%
Novanet $54 117%
Ambetter / Centene $63 137%
Blue Cross Blue Shield $67 145%
Node Us Dept Of Labor $67 145%
Healthspring $74 161%
Bp Health Advocate $84 - $93 182%
Ag Administrators $117 - $131 254%
Choicecare $117 - $131 254%
Drummond $117 - $131 254%
American Employee Alliance $134 - $149 291%
Healthchoice $167 - $224 362%
Value Options $167 - $186 362%
Multiplan $204 - $261 443%
Blue Bell Creameries $234 - $261 508%
Natl Comp Care $250 - $280 542%
Usa Ppo $250 - $280 542%
Coventry Work Comp Al $261 - $292 566%
Alabama Wc $284 - $317 616%
Cal-Med $284 - $317 616%
Corvel $284 - $317 616%
Associated Admin $301 - $336 653%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals