CMS Price Transparency Data

Orthotic fitting and training

Facility: Banner Boswell Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $71
Cash Discount Price: $20
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Banner Boswell Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.54x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $20 (43%)

Insurance Median: $71 (154%)

Cash: $20 (43% of Medicare)

Ins. Median: $71 (154% 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.

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
Aetna	$26 - $81	56%
Arizona Physicians Ipa	$26	56%
Health Net	$26 - $71	56%
Mercy Care	$26	56%
Health Choice Arizona, Inc.	$39 - $66	85%
Hospice Of The Valley	$46	100%
Arizona Priority Care	$52	113%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$59	128%
Plotkin Health	$59	128%
Oscar Health Plan	$66	143%
Quiktrip Corporation	$71	154%
Provider Network Of America	$98	213%
Arizona Medical Network	$105	228%
Blue Cross Blue Shield	$123 - $164	267%
Cigna	$203 - $225	440%
UnitedHealthcare	$241 - $265	523%

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 $20.
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 Banner Boswell Medical Center 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.