CMS Price Transparency Data

Orthotic fitting and training

Facility: PAM Rehabilitation Hospital of Tavares LLC

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $76
Cash Discount Price: $229
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at PAM Rehabilitation Hospital of Tavares LLC is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $229. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.65x the Medicare baseline. Located in 1730 Mayo Dr, Tavares, FL.

Cash / Self-Pay

$229

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $229 (497%)

Insurance Median: $76 (165%)

Cash: $229 (497% of Medicare)

Ins. Median: $76 (165% 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	$22 - $44	48%
Curative	$33	72%
Careplus	$42	91%
UnitedHealthcare	$42 - $75	91%
Humana	$43	93%
Palm Beach Aco Reach	$43	93%
Primary Care Alliance	$43	93%
Blue Cross Blue Shield	$44 - $115	95%
Ilumed Aco Reach	$44	95%
Simply Healthcare	$44	95%
Sunshine State Health Plan	$44	95%
Wellmed	$44	95%
Velocity Provider Ppo Network	$53 - $172	115%
Prime Health Services	$58 - $195	126%
Orlando Health Network	$135	293%
America'S Choice Provider Network	$160	347%
Quik Trip	$172	373%
Usa Managed Care Organization	$172	373%
Multiplan/Phcs	$183	397%

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 $229.
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 PAM Rehabilitation Hospital of Tavares LLC 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.