CMS Price Transparency Data

Orthotic fitting and training

Facility: Piedmont Eastside Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $267
Cash Discount Price: $107
vs. Medicare Baseline: 5.79x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Piedmont Eastside Medical Center is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 5.79x the Medicare baseline. Located in 1700 Medical Way, Snellville, GA.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$267

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: $107 (232%)

Insurance Median: $267 (579%)

Cash: $107 (232% of Medicare)

Ins. Median: $267 (579% 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 579% of the Medicare baseline (a markup of 479%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$52 - $111	113%
Phcs [10601]	$160 - $269	347%
Industry Buying Group [10840]	$174 - $291	378%
First Health [10303]	$187 - $314	406%
Kaiser [10500]	$198 - $332	430%
Novanet [10819]	$200 - $336	434%
Blue Cross Blue Shield	$210 - $412	456%
UnitedHealthcare	$215 - $331	466%
Multiplan [10600]	$240 - $403	521%
Aetna	$267 - $419	579%
Cigna	$267 - $419	579%

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 $107.
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 Piedmont Eastside 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.