CMS Price Transparency Data

Orthotic fitting and training

Facility: Pali Momi Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $60
Cash Discount Price: $91
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Pali Momi Medical Center is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.30x the Medicare baseline. Located in 98-1079 Moanalua Road, Aiea, HI.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

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: $91 (197%)

Insurance Median: $60 (130%)

Cash: $91 (197% of Medicare)

Ins. Median: $60 (130% 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
UnitedHealthcare	$17 - $38	37%
Alohacare	$42 - $60	91%
Ohana	$45 - $72	98%
Hmsa	$60	130%
Mdx	$60 - $122	130%
Uha	$61	132%
Devoted	$63	137%
Pac Admin	$106	230%
Mimoh	$114	247%
Hwmg/Hmaa	$115	250%
Hcha	$122	265%
Kaiser	$122	265%
Multiplan	$122 - $129	265%
Verdegard	$122	265%
Coventry	$129	280%
Mccp	$129	280%

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 $91.
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 Pali Momi 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.