CMS Price Transparency Data

Orthotic fitting and training

Facility: Atrium Health Navicent the Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $57
Cash Discount Price: $71
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Atrium Health Navicent the Medical Center is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.24x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $71 (154%)

Insurance Median: $57 (124%)

Cash: $71 (154% of Medicare)

Ins. Median: $57 (124% 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
Ambetter / Centene	$42 - $72	91%
Aetna	$43 - $97	93%
Blue Cross Blue Shield	$43 - $67	93%
Care Source	$43	93%
Clover	$43	93%
Eon Health	$43	93%
Georgia Health Advantage	$43	93%
Humana	$43 - $97	93%
Pruitt Health	$43 - $45	93%
UnitedHealthcare	$43 - $294	93%
Cigna	$47 - $266	102%
Securehealth	$49 - $74	106%
Alliant	$51 - $62	111%
Kaiser	$64 - $92	139%
Multiplan	$92 - $113	200%
Ibg	$100	217%
Novanet	$113	245%
Three Rivers Provider Network	$120	260%
Beechstreet	$131	284%

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 $71.
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 Atrium Health Navicent the Medical Center 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.