CMS Price Transparency Data

Orthotic fitting and training

Facility: North Shore Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $86
  • Cash Discount Price: $318
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at North Shore Medical Center is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $318. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.87x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$318

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: $318 (690%)
Insurance Median: $86 (187%)
Cash: $318 (690% 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.

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 $9 - $249 20%
Veterans Administration Mill Bill $33 72%
Bc/Bs Myblue Hmo Hix $39 - $46 85%
Bc/Bs Of Fl Health Options Hmo $42 - $50 91%
Bc/Bs Of Fl Ppo $42 - $50 91%
Bc/Bs Of Fl Simplyblue $42 - $50 91%
Medicare (plans) $42 - $346 91%
Bc/Bs Of Fl Network Blue $44 - $53 95%
Humana $45 - $75 98%
Devoted Health $46 100%
Dimension Health Wc $46 100%
Leon Health Inc $46 100%
UnitedHealthcare $46 - $364 100%
Workers Compensation $46 100%
Bc/Bs Of Fl Blue Select Exchange Non Par $47 - $56 102%
Employer Direct Healthcare $47 - $59 102%
Hospice Other $47 102%
Tricare $47 102%
Veterans Administration Vaccn $47 102%
Cigna $49 - $173 106%
Healthsun Health Plans $49 106%
Longevity Health Plan $50 108%
Florida Pace Centers $56 122%
Bright Health Management Commercial $57 124%
Centurion Prison $58 126%
Self Pay/Uninsured $58 126%
Medicaid / KanCare $72 - $346 156%
Avmed Exchange $83 180%
Ambetter / Centene $87 189%
Molina Marketplace Program Exchange $90 195%
Auto Insurance $94 204%
Avmed Select Network $97 210%
Amerihealth Caritas Next Exchange $102 221%
Oscar Health Plan Hix $114 247%
Bc/Bs Of Fl Phs $150 - $179 325%
Imagine Health $161 349%
Avmed Broad Network $171 371%
Magellan Behavioral Health $174 - $207 378%
Dimensions International $188 - $225 408%
First Health $197 - $235 427%
Dimension Health Ppo $217 - $259 471%
Beacon Health Strategies Commercial $290 - $346 629%
Commercial Non-Contracted $290 - $346 629%
Self Pay - Mcd Pending 100 Percent $290 - $346 629%
Single Case Agreement $290 - $346 629%
United Behavioral Health Psych $290 - $346 629%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals