CMS Price Transparency Data

Orthotic fitting and training

Facility: Gulf Breeze Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $64
Cash Discount Price: $20
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Gulf Breeze Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.39x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $20 (43%)

Insurance Median: $64 (139%)

Cash: $20 (43% of Medicare)

Ins. Median: $64 (139% 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	$15 - $151	33%
Pensacola	$20	43%
Cha Health Plan	$23	50%
UnitedHealthcare	$23 - $234	50%
Fl Community Care Ltc	$24	52%
Humana	$24 - $61	52%
Sunshine Health	$24	52%
Wellcare	$24 - $63	52%
Simply Healthcare Healthy Kids	$26	56%
Hospice Regency	$40	87%
Hospice Covenant	$60	130%
Medicare (plans)	$63	137%
Cigna	$64 - $135	139%
Hospice Emerald Coast	$68	148%
Private Healthcare	$88	191%
Uwf Athletes	$88	191%
First Health	$94	204%
Wc Corvel	$96 - $128	208%
Choicecare	$101	219%
Fl Blue	$101 - $308	219%
Multiplan	$120	260%
Bc Fl	$201	436%

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 $20.
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 Gulf Breeze Hospital 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.