CMS Price Transparency Data

Orthotic fitting and training

Facility: Marinhealth Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $342
Cash Discount Price: $166
vs. Medicare Baseline: 7.42x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Marinhealth Medical Center is $342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 7.42x the Medicare baseline. Located in 250 Bon Air Road, Greenbrae, CA.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$342

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: $166 (360%)

Insurance Median: $342 (742%)

Cash: $166 (360% of Medicare)

Ins. Median: $342 (742% 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 742% of the Medicare baseline (a markup of 642%). 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	$59	128%
Brown And Tolan	$59	128%
Healthnet Tailored Network	$59	128%
Kaiser	$59	128%
Marin Cancer Care	$59	128%
Ca Prison Health Care Services	$95	206%
Blue Cross Blue Shield	$126 - $160	273%
Healthnet Enhancedcare	$154	334%
Provider Network Of America	$282	612%
Canopy	$342	742%
Canopy Hill Physicians	$342	742%
Blue Shield Cpic/Epo	$352	764%
Providers Network Of America	$374	811%
Blue Shield Hmo/Ppo	$391	848%
Hills Blue Shield Hmo/Ppo	$391	848%
Healthnet Hmo/Ppo	$396	859%
Healthnet Hmo/Ppo Hill Physicians	$396	859%
Blue Shield Aco	$406	881%
Cigna	$662	1436%
UnitedHealthcare	$2,330	5055%

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 $166.
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 Marinhealth 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.