CMS Price Transparency Data

Orthotic fitting and training

Facility: Adventist Health Howard Memorial

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $86
Cash Discount Price: $45
vs. Medicare Baseline: 1.87x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Adventist Health Howard Memorial is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.87x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $45 (98%)

Insurance Median: $86 (187%)

Cash: $45 (98% of Medicare)

Ins. Median: $86 (187% 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
Blue Shield Mcare	$24 - $49	52%
Tricare	$24 - $49	52%
Medicare (plans)	$25 - $49	54%
Aetna	$26 - $118	56%
UnitedHealthcare	$27 - $136	59%
Cigna	$41 - $150	89%
Blue Shield - All Other Plans	$48 - $334	104%
Blue Cross Blue Shield	$53 - $598	115%
Ah Employee Health Plan - All Plans	$54 - $92	117%
Western Growers/Pinnacle - All Plans	$70 - $132	152%
Healthnet - All Plans	$71 - $144	154%
First Health Ppo - All Plans	$98 - $141	213%
Ghn Ppo - All Plans	$98 - $141	213%
Brms - All Plans	$104 - $150	226%
Medi-Cal	$122 - $176	265%
Blue Shield Epn	$327	709%

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 $45.
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 Howard Memorial 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.