CMS Price Transparency Data

Orthotic fitting and training

Facility: Fairview Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $76
Cash Discount Price: $111
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Fairview Hospital is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.65x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $111 (241%)

Insurance Median: $76 (165%)

Cash: $111 (241% of Medicare)

Ins. Median: $76 (165% 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
Aetna	$29 - $88	63%
Health New England	$38 - $147	82%
Medicaid / KanCare	$38 - $147	82%
Point32Health	$41 - $111	89%
Bmchnp	$43 - $153	93%
Other Government	$44 - $48	95%
Blue Cross Blue Shield	$45 - $99	98%
Commcare Alliance	$45 - $56	98%
Fallon	$45 - $51	98%
Medicare (plans)	$45 - $47	98%
Hospice	$46 - $48	100%
UnitedHealthcare	$46 - $100	100%
Comm Fallon Qhp	$72	156%
Workers Comp	$74	161%
Allways Nhp	$76	165%
Unicare	$76 - $81	165%
Comm Hne Hmo	$81 - $92	176%
Comm Hne Ppo	$86 - $98	187%
Capital District Physicians' Health Plan	$105	228%
Cigna	$105 - $109	228%
Mvp	$105	228%
Oxford	$105	228%
First Health	$109 - $111	236%
Connecticare	$111	241%
Consolidated Health Plans	$111	241%
Other Commercial	$111	241%
Phcs	$111	241%
Self Pay	$111	241%

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 $111.
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 Fairview 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.