CMS Price Transparency Data

Orthotic fitting and training

Facility: Mount Sinai Rehabilitation Hospital Inc

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $215
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 4.66x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mount Sinai Rehabilitation Hospital Inc is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.66x the Medicare baseline. Located in 490 Blue Hills Ave, Hartford, CT.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $174 (378%)
Insurance Median: $215 (466%)
Cash: $174 (378% of Medicare)
Ins. Median: $215 (466% 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 466% of the Medicare baseline (a markup of 366%). 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.

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 $48 - $299 104%
Blue Cross Blue Shield $48 - $316 104%
Medicare (plans) $48 - $50 104%
UnitedHealthcare $48 - $224 104%
Cca Senior Care Options $49 106%
Cigna $49 - $144 106%
Claimdoc $103 223%
Diversified Administrators $103 223%
Innovative Health Plan Ii $103 223%
Connecticut Dept Of Correction $137 297%
Allegiance $144 312%
Health Partners $144 312%
Magnacare $144 312%
Health New England $168 365%
Allied National Global Care $215 466%
Asrm - Reliance Standard Life Insurance $215 466%
Christian Care Ministry $215 466%
Dean Health $215 466%
Family Life Insurance Company $215 466%
Ghc Scw $215 466%
International Benefit Administrators $215 466%
Lifetime Benefit Solutions $215 466%
Manhattan Life $215 466%
Medi Share $215 466%
Multiplan $215 466%
Mvp $215 466%
Pai $215 466%
Pan-American Life $215 466%
Paramount Hmo $215 466%
Phcs $215 466%
Trinity Health Share $215 466%
Geha $224 486%
Harvard Pilgrim Healthcare $224 486%
Prime Health Services $253 549%
Health Smart $269 584%
1199 National Benefit Fund $299 649%
Allied Benefit Systems $299 649%
Gravie Admin Services $299 649%
Hap $299 649%
Luminare Health $299 649%
Meritain $299 649%
Nippon Life Ins $299 649%
Webtpa $299 649%
Bcn Domestic $316 686%
Blue Benefit Administrators Of Massachusetts $316 686%
Blue Care Network $316 686%
Blue Distinction Transplant $316 686%
Blue Shield - Ca $316 686%
Blue Shield - Id (Regence) $316 686%
Blue Shield - Ny Highmark Northeastern $316 686%
Blue Shield - Ny Highmark Western $316 686%
Blue Shield - Pa (Highmark) $316 686%
Blue Shield - Wa (Regence) $316 686%
Health Choices $316 686%
Kaiser Domestic $316 686%
Pre-Employment $316 686%
Unicare $316 686%
Wc Domestic $316 686%
Connecticare $354 - $402 768%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 490 Blue Hills Ave, Hartford, CT 06112
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL