Orthotic fitting and training
Facility: Adventist Health Tulare
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $121
- Cash Discount Price: $35
- vs. Medicare Baseline: 2.63x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 263% of the Medicare baseline (a markup of 163%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $27 - $132 | 59% |
| Blue Shield Epn | $45 - $256 | 98% |
| Blue Cross Blue Shield | $46 - $410 | 100% |
| Blue Shield-All Other Plans | $48 - $356 | 104% |
| Blue Shield Mcare | $49 | 106% |
| Dignity Mcr Op Only - All Other Plans | $49 | 106% |
| Fhcn Pace Mcr Adv - All Plans | $49 | 106% |
| Medicare (plans) | $49 | 106% |
| Prime Health - All Plans | $49 | 106% |
| Tricare | $49 | 106% |
| UnitedHealthcare | $49 - $602 | 106% |
| Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot | $49 | 106% |
| Ah Employee Health Plan - All Plans | $54 - $88 | 117% |
| Incentive Hlth - All Plans | $54 - $88 | 117% |
| Hs Interplan-All Plans | $61 - $151 | 132% |
| Cigna | $62 - $105 | 135% |
| Prison Hlthcre - All Plans | $63 | 137% |
| Cal Forensic Med Grp - All Plans | $64 | 139% |
| Bright Health - All Plans | $71 | 154% |
| Healthnet Hmo/Ppo - All Other Plans | $71 - $131 | 154% |
| Western Growers - All Plans | $86 - $106 | 187% |
| Network By Design-All Plans | $120 - $147 | 260% |
| Ccipa Medi-Cal - All Plans | $122 - $294 | 265% |
| Healthnet Medi-Cal | $122 - $296 | 265% |
| Medi-Cal | $122 - $226 | 265% |
| Upn-United Physcn Ntwrk Mcal Profee Only | $122 | 265% |
| Multiplan - All Plans | $156 - $192 | 338% |
| Dignity Mcal Op Only | $202 - $249 | 438% |
| Independence Op Only - All Plans | $202 - $249 | 438% |