CMS Price Transparency Data

Orthotic fitting and training

Facility: Encino Hospital Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $53
Cash Discount Price: $51
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Encino Hospital Medical Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.15x the Medicare baseline. Located in 16237 Ventura Blvd, Encino, CA.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $51 (111%)

Insurance Median: $53 (115%)

Cash: $51 (111% of Medicare)

Ins. Median: $53 (115% 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
Aids Healthcare Foundation	$52 - $53	113%
Alignment	$52	113%
Blue Shield Of Ca, Va	$52	113%
Blue Shield Of Promise	$52	113%
Brand New Day	$52 - $78	113%
Health Net Of Ca	$52 - $76	113%
La Care Health Plan	$52	113%
Managed Health Network	$52	113%
Medicare (plans)	$52	113%
Molina	$52	113%
Renal Payer Solutions	$52	113%
Tricare	$52	113%
Usa Senior Care Network	$52	113%
Imperial Health Plan Ca	$55	119%
Corvel	$65	141%
Zelis Healthcare	$65	141%
Aetna	$66	143%
Americas Choice Provider Network	$66	143%
Multiplan	$66	143%
Prime Health Services, Inc.	$66	143%
Three Rivers	$66	143%
Healthsmart Preferred Care Network	$67	145%
Provider Network Of America	$68	148%
Provider Select	$68	148%
Workers Comp	$68	148%
Employer Direct Healthcare	$73	158%

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 $51.
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 Encino Hospital 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.