CMS Price Transparency Data

Orthotic fitting and training

Facility: Adventist Health Ukiah Valley

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $174
Cash Discount Price: $41
vs. Medicare Baseline: 3.78x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Adventist Health Ukiah Valley is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.78x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $41 (89%)

Insurance Median: $174 (378%)

Cash: $41 (89% of Medicare)

Ins. Median: $174 (378% 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 378% of the Medicare baseline (a markup of 278%). 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
Aetna	$26 - $188	56%
Blue Shield Epn-All Other Plans	$45 - $290	98%
Blue Shield Non-Epn	$48 - $297	104%
Blue Shield Mcr Adv	$49	106%
Kaiser Mcr Adv	$49	106%
Tricare	$49	106%
UnitedHealthcare	$49 - $237	106%
Ah Employee Health Plan - All Plans	$54 - $88	117%
Cigna	$62 - $222	135%
Blue Cross Blue Shield	$66 - $634	143%
Western Growers-All Plans	$70 - $309	152%
Healthnet-All Plans	$71 - $162	154%
Mendocino Lcc District-All Plans	$79 - $185	171%
Kaiser-All Other Plans	$98 - $227	213%
Three Rivers-All Plans	$110 - $256	239%
Kaiser Medi-Cal	$122 - $284	265%
Medi-Cal	$122 - $284	265%
Foundation For Medical Care-All Plans	$213	462%
Networks By Design-All Plans	$227	493%
Phcs Multiplan-All Plans	$227	493%
Interplan-All Plans	$233	506%
Beech Street-All Plans	$241	523%
Choice Care-All Plans	$241	523%
Health Mgmt Network-All Plans	$241	523%

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 $41.
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 Adventist Health Ukiah Valley 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.