Orthotic fitting and training
Facility: Medstar Harbor Hospital
Billing Code: 97760 (CPT)
- CPT Billing Code: 97760
- Insurance Median: $348
- Cash Discount Price: $341
- vs. Medicare Baseline: 7.55x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 755% of the Medicare baseline (a markup of 655%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $213 - $387 | 462% |
| Amerigroup | $213 - $387 | 462% |
| Amerihealth Caritas District Of Columbia | $213 - $387 | 462% |
| Carefirst Advantage Inc | $213 - $387 | 462% |
| Carefirst Blue Choice Inc | $213 - $387 | 462% |
| Cigna | $213 - $387 | 462% |
| First Health | $213 - $387 | 462% |
| Hscsn | $213 - $387 | 462% |
| Humana | $213 - $387 | 462% |
| Kaiser Permanente | $213 - $387 | 462% |
| Magellan Behavioral Health Inc | $213 - $387 | 462% |
| Mamsi | $213 - $387 | 462% |
| Medstar Family Choice | $213 - $387 | 462% |
| Medstar Family Choice Inc | $213 - $387 | 462% |
| Ncppo Healthlink Ppo | $213 - $387 | 462% |
| Pfc | $213 - $387 | 462% |
| Private Healthcare Systems (Phcs) | $213 - $387 | 462% |
| Tricare | $213 - $387 | 462% |
| United Behavioral Health Inc | $213 - $387 | 462% |
| UnitedHealthcare | $213 - $387 | 462% |
Consumer Guidance & Cost Commentary
For the CPT code 97760 (Orthotic fitting and training) at Medstar Harbor Hospital in Baltimore, the cash median price is $341. This cash rate is significantly lower than the facility's gross charge of $348 and aligns with the median negotiated rate of $348 reported for this service. While the facility is a Voluntary non-profit - Private Acute Care Hospital with a 4-star rating, patients should note that commercial insurance negotiated rates for this procedure range from $213 to $387 across 20 different payers, meaning the cash price could be more cost-effective for those with high-deductible plans or those who do not have insurance coverage.
The Medicare benchmarking for this specific service is $46.09, which serves as a critical baseline for understanding the markup on commercial pricing. Although the data indicates a 7.6% variance versus Medicare, the wide spread between the lowest negotiated rate of $213 and the highest rate of $387 highlights significant price variation depending on the insurance plan. Patients are encouraged to explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can often bypass the administrative costs associated with insurance claims and result in a lower final bill than the standard cash median. Additionally, if a patient encounters a balance bill after receiving care, they should request an itemized audit to verify that all charges are accurate and in compliance with the No Surprises Act.