CMS Price Transparency Data

Orthotic fitting and training

Facility: Massachusetts General Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $175
Cash Discount Price: $181
vs. Medicare Baseline: 3.80x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Massachusetts General Hospital is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.80x the Medicare baseline. Located in 55 Fruit Street, Boston, MA.

Cash / Self-Pay

$181

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $181 (393%)

Insurance Median: $175 (380%)

Cash: $181 (393% of Medicare)

Ins. Median: $175 (380% 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 380% of the Medicare baseline (a markup of 280%). 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
UnitedHealthcare	$51 - $215	111%
Generic Commercial [1009]	$52	113%
Mgb Health Plan [150001]	$80 - $101	174%
Harvard Pilgrim [120001]	$115	250%
Cigna	$117 - $209	254%
Harvard Pilgrim Alternate [120002]	$120	260%
Aetna	$153 - $211	332%
Centers Of Excellence [1026]	$157 - $189	341%
International Commercial [140001]	$176 - $215	382%
Tricare	$208 - $250	451%

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 $181.
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 Massachusetts General 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.