CMS Price Transparency Data

Orthotic fitting and training

Facility: Oak Valley Hospital District

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $139
Cash Discount Price: $134
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Oak Valley Hospital District is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.02x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $134 (291%)

Insurance Median: $139 (302%)

Cash: $134 (291% of Medicare)

Ins. Median: $139 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
Alignment Op Only Ip/Op Only-All Plans	$49	106%
Humana	$49	106%
Kaiser Mcr Adv Ip/Op Only	$49	106%
Scan Health Plan Ip/Op Only-All Plans	$50	108%
Imperial Health Ip/Op Only-All Plans	$54	117%
Healthnet Comm Op Only Ip/Op Only-All Other Plans	$94 - $117	204%
UnitedHealthcare	$95 - $119	206%
Kaiser Comm Ip/Op Only-All Other Plans	$99 - $123	215%
Cigna	$107 - $133	232%
Blue Cross Blue Shield	$111 - $198	241%
Blue Shield Epn Ip/Op Only	$111 - $138	241%
Aetna	$135 - $168	293%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$143 - $178	310%
Healthnet Medi-Cal Ip/Op Only	$159 - $198	345%
Kaiser Medi-Cal Ip/Op Only	$159 - $198	345%
Medi-Cal Ip/Op Only	$159 - $198	345%
Hp Of San Joaquin Ip/Op Only-All Plans	$191 - $238	414%

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 $134.
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 Oak Valley Hospital District 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.