CMS Price Transparency Data

Orthotic fitting and training

Facility: City of Hope National Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $133
Cash Discount Price: $151
vs. Medicare Baseline: 2.89x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at City of Hope National Medical Center is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.89x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$133

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: $151 (328%)

Insurance Median: $133 (289%)

Cash: $151 (328% of Medicare)

Ins. Median: $133 (289% 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 289% of the Medicare baseline (a markup of 189%). 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
Health Net	$42 - $192	91%
Cal Optima	$52	113%
Heritage Provider Network	$65 - $114	141%
Inland Empire	$65 - $131	141%
Blue Cross Blue Shield	$70 - $327	152%
UnitedHealthcare	$78 - $327	169%
Blue Shield	$82 - $327	178%
Prime Healthcare Keenan	$91 - $157	197%
Blue Shield Promise	$97 - $114	210%
Cencal	$111 - $131	241%
La Care Health	$111 - $131	241%
Kaiser	$125 - $147	271%
Aetna	$139 - $164	302%
Gold Coast	$139 - $164	302%
Molina	$139 - $213	302%
Cigna	$149 - $176	323%
Facey	$153 - $180	332%
Healthcare Partners	$161 - $190	349%
St. Joseph Heritage	$167 - $196	362%
Primecare Medical Network	$181 - $213	393%
First Health	$214 - $252	464%
Blue Shield Covca	$238	516%
Phcs Multiplan	$250 - $294	542%

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 $151.
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 City of Hope National 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.