CMS Price Transparency Data

Orthotic fitting and training

Facility: Loma Linda University Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $163
Cash Discount Price: $99
vs. Medicare Baseline: 3.54x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Loma Linda University Medical Center is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.54x the Medicare baseline. Located in 11234 Anderson St, Loma Linda, CA.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$163

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: $99 (215%)

Insurance Median: $163 (354%)

Cash: $99 (215% of Medicare)

Ins. Median: $163 (354% 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 354% of the Medicare baseline (a markup of 254%). 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
Adventist Health	$44 - $90	95%
Lluh Dept Of Risk Management	$44 - $90	95%
Kaiser Foundation Hospitals	$84 - $147	182%
Epic Health Plan	$88	191%
Riverside University Health System	$88	191%
Alpha Care Medical Group	$121 - $187	263%
Global Benefits Group	$132	286%
Temecula Valley Physicians Medical Group	$132	286%
Trivalley Medical Group	$132	286%
Aetna	$134	291%
Cigna	$141 - $163	306%
Networks By Design	$143	310%
Molina Healthcare Of Ca	$154	334%
Multiplan	$165	358%
Central Health Plan	$176	382%
Dignity Health	$187	406%
Galaxy Health	$187	406%
Prime Health Services	$187	406%
Vantage Medical Group	$187	406%
Health Management Network	$198	430%
UnitedHealthcare	$206 - $417	447%
Blue Shield Of California	$268 - $412	581%
Blue Cross Blue Shield	$336 - $447	729%

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 $99.
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 Loma Linda University 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.