CMS Price Transparency Data

Orthotic fitting and training

Facility: Adventist Health Twin Cities

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $280
Cash Discount Price: $22
vs. Medicare Baseline: 6.08x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Adventist Health Twin Cities is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 6.08x the Medicare baseline. Located in 1100 Las Tablas Rd, Templeton, CA.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$280

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: $22 (48%)

Insurance Median: $280 (608%)

Cash: $22 (48% of Medicare)

Ins. Median: $280 (608% 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 608% of the Medicare baseline (a markup of 508%). 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	$50 - $474	108%
Cencal Mcr Adv - All Other Plans	$50	108%
Tricare	$50	108%
UnitedHealthcare	$50 - $431	108%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$65	141%
Ah Employee Health Plan - All Plans	$90	195%
Hpn-Heritage Prov Ntwrk-All Plans	$100 - $109	217%
Chn-Community Hlth Ntwrk-All Plans	$162 - $176	351%
Nbd-Ntwrks By Design Exlus-All Other Plans	$170 - $185	369%
Nbd-Ntwrks By Design Non-Exlus	$170 - $185	369%
Blue Shield Epn	$244	529%
Pacific Health Alliance-All Plans	$266 - $288	577%
Blue Shield Hmo/Pos	$280	608%
Medi-Cal	$295 - $320	640%
Blue Shield Epo/Ppo - All Other Plans	$329	714%
Cencal Mcal	$336 - $365	729%
Blue Shield Promise Mcal	$355 - $385	770%
Ccah-Centrl Ca Allince Mcal-All Plans	$384 - $416	833%
Coalinga-All Plans	$384 - $416	833%

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 $22.
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 Twin Cities 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.