CMS Price Transparency Data

Orthotic fitting and training

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $130
Cash Discount Price: $159
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Sharp Coronado Hospital and Hlthcr Ctr is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.82x the Medicare baseline. Located in 250 Prospect Place, Coronado, CA.

Cash / Self-Pay

$159

Average discount available for prompt cash payment at this facility.

Insurance Median

$130

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: $159 (345%)

Insurance Median: $130 (282%)

Cash: $159 (345% of Medicare)

Ins. Median: $130 (282% 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 282% of the Medicare baseline (a markup of 182%). 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	$13 - $191	28%
Managed Health Network	$13 - $163	28%
Blue Shield	$30 - $148	65%
Indian Health Council	$59 - $72	128%
Aetna	$63 - $191	137%
County Medical Services	$63 - $191	137%
Humana	$63 - $106	137%
Blue Cross Blue Shield	$65 - $135	141%
Epic Americas	$72 - $135	156%
Medi-Cal	$102 - $159	221%
Molina	$102 - $163	221%
Interplan	$117	254%
Cigna	$118 - $129	256%
San Diego Pace	$118 - $148	256%
Community Health Group	$120 - $148	260%
UnitedHealthcare	$120 - $159	260%
Kaiser	$129	280%
Allianz Global Assistance	$135 - $159	293%
California Health And Wellness	$159	345%
Multiplan	$159	345%
Medicare (plans)	$191	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 $159.
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 Sharp Coronado Hospital and Hlthcr Ctr 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.