CMS Price Transparency Data

Orthotic fitting and training

Facility: Mt Sinai Hospital Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $80
  • Cash Discount Price: $108
  • vs. Medicare Baseline: 1.74x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mt Sinai Hospital Medical Center is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.74x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$108

Average discount available for prompt cash payment at this facility.

Insurance Median
$80

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: $108 (234%)
Insurance Median: $80 (174%)
Cash: $108 (234% of Medicare)
Ins. Median: $80 (174% 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.

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
Blue Cross Blue Shield $44 - $231 95%
Cigna $44 - $243 95%
Partners In Hlth - All Plans $44 - $80 95%
Tricare $45 98%
Va Healthnet - All Plans $45 98%
Advocate Physician Prtnrs Mcr $47 102%
Cenpatico Illinicare Dual $47 102%
Cenpatico Illinicare Mcr - All Other Plans $47 102%
Humana $47 - $626 102%
Lawndale Christian - All Plans $47 102%
Meridian/Harmony D-Snp - All Plans $47 102%
Nextlevel Hlth Icp Fhp Aca - All Plans $47 102%
UnitedHealthcare $47 - $171 102%
Harmony Behavioral Htlh - All Plans $48 104%
Molina Mcr - All Other Plans $49 106%
Oscar - All Plans $49 - $120 106%
Zing Mcr Adv - All Plans $49 106%
Advocate Physician Prtnrs - All Other Plans $51 111%
Ambetter / Centene $51 - $209 111%
Compsych Ip/Op Only - All Plans $65 - $120 141%
Healthlink Hmo $71 - $130 154%
Hfn Platinum $71 - $130 154%
Healthlink Ppo - All Other Plans $76 - $140 165%
Multiplan Primary Ntwrk/Phcs - All Other Plans $76 - $140 165%
Hfn Epo $87 - $159 189%
Multiplan Complementary Ntwrk $87 - $159 189%
Hfn Ppo - All Other Plans $96 - $175 208%
Aetna $231 - $451 501%
Family Health Network Mcaid - All Plans $231 501%
Molina Mcaid $243 527%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals