CMS Price Transparency Data

Orthotic fitting and training

Facility: Athur M Blank Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $217
Cash Discount Price: $316
vs. Medicare Baseline: 4.71x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Athur M Blank Hospital is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $316. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.71x the Medicare baseline. Located in 2220 North Druid Hills Road Ne, Atlanta, GA.

Cash / Self-Pay

$316

Average discount available for prompt cash payment at this facility.

Insurance Median

$217

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: $316 (686%)

Insurance Median: $217 (471%)

Cash: $316 (686% of Medicare)

Ins. Median: $217 (471% 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 471% of the Medicare baseline (a markup of 371%). 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
Amerigroup [102]	$27	59%
Peachstate [43]	$135	293%
Caresource [61]	$139	302%
Cigna	$209	453%
Blue Cross Blue Shield	$210 - $308	456%
United [5]	$210	456%
Ambetter / Centene	$212	460%
Oscar [228]	$212	460%
Aetna	$213	462%
Caresource Marketplace Bronze/Silver/Gold [60]	$215	466%
Kaiser [6]	$215	466%
Sidecar Health [236]	$218	473%
Direct Employer Agreements [72]	$221 - $269	479%
Coventry [9]	$222	482%
First Health [74]	$237	514%
Northeast Georgia Heatlh System [808]	$237	514%
Veracity Benefits [809]	$237	514%
Phcs [93]	$269	584%
Secure Health [340]	$269	584%
Beech Street [71]	$284	616%
Multiplan [92]	$310	673%
Novanet [41]	$316	686%

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 $316.
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 Athur M Blank 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.