CMS Price Transparency Data

Orthotic fitting and training

Facility: San Antonio Regional Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $244
  • Cash Discount Price: $249
  • vs. Medicare Baseline: 5.29x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at San Antonio Regional Hospital is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 5.29x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$249

Average discount available for prompt cash payment at this facility.

Insurance Median
$244

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: $249 (540%)
Insurance Median: $244 (529%)
Cash: $249 (540% of Medicare)
Ins. Median: $244 (529% 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 529% of the Medicare baseline (a markup of 429%). 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
Tricare $48 104%
Blue Shield Mcr Adv $49 106%
Caremore Mcr Adv - All Plans $49 106%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $49 106%
Healthnet Mcr Adv $49 106%
Humana $49 106%
Iehp Mcr Adv $49 106%
Inter Valley Hp Mcr Adv- All Plans $49 106%
Kindred Mcr Adv-All Plans $49 106%
Molina Mcr Adv $49 106%
Scan Health Plan Mcr Adv-All Plans $49 106%
Universal Care - All Plans $49 106%
Blue Cross Blue Shield $50 - $489 108%
Zelis Mcr Adv $52 113%
Kasiser Mcr Adv $53 115%
Imperial Health Mcr Adv-All Plans $54 117%
Choice Phycn Ntwrk Op Only $61 132%
Molina Exchange-All Other Plans $64 139%
Aetna $66 - $414 143%
Iehp Comm - All Other Plans $71 154%
Redlands Employee $74 161%
Ambetter / Centene $75 163%
Redlands Hmo-All Other Plans $77 167%
Prime Health - All Plans $86 187%
Blue Shield Epn $88 191%
Healthnet - All Other Plans $118 256%
Coventry Ccn/First Hlth - All Plans $120 260%
Epic Health Plan - All Other Plans $124 269%
Kaiser Comm - All Other Plans $137 297%
UnitedHealthcare $157 - $270 341%
Pc Inland Valley Scan $207 449%
Pc Inland Valley-All Other Plans $207 449%
Blue Shield Epo Ppo - All Other Plans $244 529%
Blue Shield Hmo Pos / Calpers Ppo $244 529%
Choicecare Ntwrk-All Plans $298 647%
Multiplan/Phcs - All Plans $298 647%
Networks By Design - All Plans $310 673%
Zelis Comm-All Other Plans $310 673%
Foundation Inland Epo-All Other Plans $331 718%
Foundation Inland Ppo $352 764%
Health Payors - All Plans $373 809%
Interplan - All Plans $373 809%
Wellcare/Easy Choice-All Plans $406 881%
Alpha Care Mg Mcr Adv $414 898%
Central Hlth Plan Mcr Adv-All Plans $414 898%
Epic Health Plan Mcr Adv $414 898%
Medi-Cal $414 898%
Prospect Hp-All Plans $414 898%
Providence Clevercare Mcr Adv $414 898%
Heritage Prov Ntwrk/Regal Mcr Adv $420 911%
Clever Care Mcr Adv - All Plans $435 944%
Kaiser Medi-Cal $435 944%
La Salle Hp Mcr Adv-All Plans $435 944%
Healthnet Medi-Cal $437 948%
Alpha Care Mg Mcal/Hlthy Kids $455 987%
Heritage Prov Ntwrk/Regal Mcal $455 987%
Molina Medi-Cal $476 1033%
Alpha Care Mg-All Other Plans $518 1124%
Iehp Mcal $538 1167%
Cigna $599 1300%
Providence Oscar-All Other Plans $600 1302%
Heritage Prov Ntwrk/Regal - All Other Plans $761 1651%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals