CMS Price Transparency Data

Orthotic fitting and training

Facility: Adventist Health Tehachapi Valley

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $72
Cash Discount Price: $38
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Adventist Health Tehachapi Valley is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.56x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $38 (82%)

Insurance Median: $72 (156%)

Cash: $38 (82% of Medicare)

Ins. Median: $72 (156% 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.

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 - $116	56%
Healthnet Mcare	$26 - $49	56%
Medicare (plans)	$26 - $46	56%
Tricare	$26 - $49	56%
UnitedHealthcare	$26 - $119	56%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$26 - $49	56%
Network Providers- All Plans	$34 - $59	74%
Cigna	$41 - $190	89%
Klhp-Kern Legacy Epo -All Other Plans	$44 - $55	95%
Blue Shield Epn- All Other Plans	$45 - $98	98%
Kaiser Ip/Op Only- All Other Plans	$45 - $79	98%
Blue Shield Non-Epn	$48 - $171	104%
Blue Cross Blue Shield	$53 - $147	115%
Ah Employee Health Plan - All Plans	$54 - $129	117%
Oscar Health Plan- All Plans	$56 - $79	122%
Western Grwrs/Pinnacle - All Plans	$58 - $102	126%
Centivo - All Plans	$59 - $104	128%
Coventry- All Plans	$59 - $219	128%
Healthnet- All Other Plans	$72 - $187	156%
Medi-Cal	$122 - $243	265%
Universal Ipa Mcal Op/Profee Only	$122 - $243	265%
Kaiser Medi-Cal Ip/Op Only	$139 - $243	302%
Bc Mcal	$143 - $250	310%
Healthnet Medi-Cal	$171 - $298	371%
Khs-Kern Hlth Systm Mcal	$179 - $313	388%

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 $38.
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 Tehachapi 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.