CMS Price Transparency Data
Orthotic fitting and training
Facility: Palmetto General Hospital
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $56
- Cash Discount Price: $287
- vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Palmetto General Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $287. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.22x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$287
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: $287 (623%)
Insurance Median: $56 (122%)
Cash: $287 (623% 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.
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 - $204 | 20% |
| Veterans Administration Mill Bill | $33 | 72% |
| Medicare (plans) | $42 - $287 | 91% |
| Bc/Bs Myblue Hmo Hix | $44 | 95% |
| Bc/Bs Of Fl Health Options Hmo | $44 | 95% |
| Bc/Bs Of Fl Network Blue | $44 | 95% |
| Bc/Bs Of Fl Simplyblue | $44 | 95% |
| Humana | $45 - $75 | 98% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $46 | 100% |
| Devoted Health | $46 | 100% |
| Dimension Health Wc | $46 | 100% |
| Leon Health Inc | $46 | 100% |
| UnitedHealthcare | $46 - $362 | 100% |
| Workers Compensation | $46 | 100% |
| Bristol Hospice- Miami Dade Llc | $47 | 102% |
| Catholic Hospice | $47 | 102% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $47 | 102% |
| Employer Direct Healthcare | $47 - $59 | 102% |
| Hospice Other | $47 | 102% |
| Ima Evalutations Inc | $47 | 102% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $47 | 102% |
| Opuscare Of South Fl | $47 | 102% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $47 | 102% |
| Select Specialty Hospital | $47 | 102% |
| Tricare | $47 | 102% |
| Veterans Administration Vaccn | $47 | 102% |
| Vitas Healthcare Hospice | $47 | 102% |
| Westchester General Hospital | $47 | 102% |
| Bc/Bs Of Fl Ppo | $49 | 106% |
| Cigna | $49 - $143 | 106% |
| Healthsun Health Plans | $49 | 106% |
| Longevity Health Plan | $50 | 108% |
| Florida Pace Centers | $56 | 122% |
| Bright Health Management Commercial | $57 | 124% |
| Bc/Bs Of Fl Miami Dade Blue Select | $58 | 126% |
| Self Pay/Uninsured | $58 | 126% |
| Naphcare Inc | $65 | 141% |
| Medicaid / KanCare | $72 - $287 | 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% |
| Liga Contra El Cancer | $143 | 310% |
| Bc/Bs Of Fl Phs | $144 | 312% |
| Imagine Health | $161 | 349% |
| Magellan Behavioral Health | $172 | 373% |
| Avmed Broad Network | $174 | 378% |
| Dimensions International | $186 | 404% |
| First Health | $192 | 417% |
| Dimension Health Ppo | $215 | 466% |
| Beacon Health Strategies Commercial | $287 | 623% |
| Commercial Non-Contracted | $287 | 623% |
| Self Pay - Mcd Pending 100 Percent | $287 | 623% |
| Single Case Agreement | $287 | 623% |
| United Behavioral Health Psych | $287 | 623% |