CMS Price Transparency Data

Orthotic fitting and training

Facility: Valley Presbyterian Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $131
Cash Discount Price: $212
vs. Medicare Baseline: 2.84x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Valley Presbyterian Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $212. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.84x the Medicare baseline. Located in 15107 Vanowen St, Van Nuys, CA.

Cash / Self-Pay

$212

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $212 (460%)

Insurance Median: $131 (284%)

Cash: $212 (460% of Medicare)

Ins. Median: $131 (284% 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 284% of the Medicare baseline (a markup of 184%). 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
Blue Shield Promise Medi-Cal	$50 - $56	108%
Blue Shield Senior	$51	111%
Aetna	$52 - $127	113%
Blue Cross Blue Shield	$52 - $143	113%
Health Net Senior	$52	113%
La Care Covered California	$52	113%
Medicare (plans)	$52 - $55	113%
Ambetter / Centene	$74	161%
Heritage Provider Network (Regal & Lakeside)	$81	176%
Health Net	$103	223%
Cigna	$107 - $120	232%
La Care Medi-Cal	$120 - $134	260%
Phcs	$120 - $134	260%
Coventry Health Care (Ccn)	$140 - $156	304%
UnitedHealthcare	$143 - $253	310%
Beech Street	$150 - $167	325%
Multiplan	$180 - $201	391%
Blue Shield Ifp	$261	566%
Blue Shield	$299	649%

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 $212.
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 Valley Presbyterian Hospital 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.