CMS Price Transparency Data

Orthotic fitting and training

Facility: Fishermen's Community Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $143
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 3.10x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Fishermen's Community Hospital is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.10x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$143

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: $164 (356%)
Insurance Median: $143 (310%)
Cash: $164 (356% of Medicare)
Ins. Median: $143 (310% 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 310% of the Medicare baseline (a markup of 210%). 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
Amerigroup $22 48%
Medicaid / KanCare $22 - $24 48%
UnitedHealthcare $22 - $253 48%
Aetna $23 - $194 50%
Sunshine State $23 50%
Vista $23 50%
Wellcare $23 50%
Blue Cross Blue Shield $42 - $253 91%
Leon Medical $53 115%
Medica Health Plan $53 115%
Medicare (plans) $53 - $72 115%
Avmed $58 - $209 126%
Humana $58 126%
Cigna $61 - $202 132%
Non Contracted $93 202%
International $164 356%
Amerihealth $190 412%
Dimension Health Plan $190 - $228 412%
Affordable $228 495%
Phcs $228 495%
Quality Health $228 495%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Overseas Hwy, Marathon, FL 33050
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals