CMS Price Transparency Data

Orthotic fitting and training

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $56
Cash Discount Price: $303
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Shriners Hospitals for Children Northern Calif is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $303. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.22x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$303

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $303 (657%)

Insurance Median: $56 (122%)

Cash: $303 (657% of Medicare)

Ins. Median: $56 (122% 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	$44 - $49	95%
Ambetter / Centene	$44 - $56	95%
Molina Healthcare Of Ms	$44	95%
Northbay Healthcare	$49	106%
Amerihealth Caritas Nc	$50	108%
Amerihealth Caritas Sc	$50	108%
Caresource Of Oh	$50	108%
Sutter Medical Foundation	$54	117%
Health Net Of Ca	$56	122%
Sana Benefits	$61 - $69	132%
Kaiser Permanente	$100	217%
Blue Cross Blue Shield	$113 - $307	245%
Cigna	$130	282%
Providence Health Plan	$139	302%
UnitedHealthcare	$167 - $180	362%
Dignity Health	$233	506%

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 $303.
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 Shriners Hospitals for Children Northern Calif 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.