CMS Price Transparency Data

Orthotic fitting and training

Facility: Hialeah Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $49
  • Cash Discount Price: $316
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Hialeah Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $316. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.06x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$316

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $316 (686%)
Insurance Median: $49 (106%)
Cash: $316 (686% of Medicare)
Ins. Median: $49 (106% 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 - $228 20%
Veterans Administration Mill Bill $33 72%
Bc/Bs Myblue Hmo Hix $42 91%
Medicare (plans) $42 - $102 91%
Bc/Bs Of Fl Health Options Hmo $45 98%
Bc/Bs Of Fl Simplyblue $45 98%
Humana $45 - $75 98%
Devoted Health $46 100%
Dimension Health Wc $46 100%
Leon Health Inc $46 100%
UnitedHealthcare $46 - $355 100%
Workers Compensation $46 100%
Bristol Hospice- Miami Dade Llc $47 102%
Catholic Hospice $47 102%
Comprehensive Home Health Care Dba Opuscare Of South Florida $47 102%
Employer Direct Healthcare $47 - $59 102%
Hcr Manor Care Services Of Fl $47 102%
Hospice Other $47 102%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $47 102%
Seasons Hospice And Pallative Care Of Southern Florida Inc $47 102%
Tricare $47 102%
Veterans Administration Vaccn $47 102%
Vitas Healthcare Hospice Corporation Of Fl $47 102%
Vitas Hospice Unit Agreement $47 102%
Bc/Bs Of Fl Miami Dade Blue Select $48 104%
Bc/Bs Of Fl Network Blue $48 104%
Bc/Bs Of Fl Ppo $48 104%
Cigna $49 - $93 106%
Healthsun Health Plans $49 106%
Longevity Health Plan $49 106%
Bc/Bs Of Fl Blue Select Exchange Non Par $51 111%
Florida Pace Centers $56 122%
Bright Health Management Commercial $57 124%
Self Pay/Uninsured $58 126%
Naphcare Inc $65 141%
Medicaid / KanCare $79 171%
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%
Imagine Health $161 349%
Avmed Broad Network $163 354%
Bc/Bs Of Fl Phs $164 356%
Dimensions International $205 445%
First Health $215 466%
Dimension Health Ppo $237 514%
Commercial Non-Contracted $316 686%
Self Pay - Mcd Pending 100 Percent $316 686%
Single Case Agreement $316 686%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals