CMS Price Transparency Data
Orthotic fitting and training
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $129
- Cash Discount Price: $133
- vs. Medicare Baseline: 2.80x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at St Joe Mercy Hospital System Livonia is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.80x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$133
Average discount available for prompt cash payment at this facility.
Insurance Median
$129
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: $133 (289%)
Insurance Median: $129 (280%)
Cash: $133 (289% of Medicare)
Ins. Median: $129 (280% 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 280% of the Medicare baseline (a markup of 180%). 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.
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 | $25 - $63 | 54% |
| Medicaid / KanCare | $25 | 54% |
| Aetna | $45 - $118 | 98% |
| Blue Care Network Advantage | $45 | 98% |
| Hospice Of Michigan | $45 | 98% |
| Medicare (plans) | $45 - $48 | 98% |
| Align Senior Care | $46 | 100% |
| Angela Hospice | $46 | 100% |
| UnitedHealthcare | $47 - $131 | 102% |
| Cca - Zing Health | $48 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $51 | 111% |
| Wc Accident Fund | $58 | 126% |
| Wc Advantage | $58 | 126% |
| Wc Aig | $58 | 126% |
| Wc Allied | $58 | 126% |
| Wc Amerisure | $58 | 126% |
| Wc Amtrust | $58 | 126% |
| Wc Asu Risk Mgt | $58 | 126% |
| Wc Berkley Admin | $58 | 126% |
| Wc Broadspire | $58 | 126% |
| Wc Bunch & Associates | $58 | 126% |
| Wc Ccmsi | $58 | 126% |
| Wc Emc Insurance Company | $58 | 126% |
| Wc Esis | $58 | 126% |
| Wc Fcci | $58 | 126% |
| Wc Federated | $58 | 126% |
| Wc Gallagher Bassett | $58 | 126% |
| Wc Genex Care For Ohio | $58 | 126% |
| Wc Guard Insurance Company | $58 | 126% |
| Wc Hartford | $58 | 126% |
| Wc Liberty Mutual | $58 | 126% |
| Wc Meijers | $58 | 126% |
| Wc Michigan | $58 | 126% |
| Wc Mitchell Frankenmuth | $58 | 126% |
| Wc Pma | $58 | 126% |
| Wc Sedgwick | $58 | 126% |
| Wc Sentry | $58 | 126% |
| Wc Travelers | $58 | 126% |
| Wc Tristar | $58 | 126% |
| Wc Walmart | $58 | 126% |
| Wc Zurich | $58 | 126% |
| Molina Marketplace | $59 | 128% |
| Bcn Domestic | $63 | 137% |
| Blue Benefit Administrators Of Massachusetts | $63 | 137% |
| Blue Care Network | $63 | 137% |
| Blue Distinction Transplant | $63 | 137% |
| Blue Shield - Ca | $63 | 137% |
| Blue Shield - Id (Regence) | $63 | 137% |
| Blue Shield - Ny Highmark Northeastern | $63 | 137% |
| Blue Shield - Ny Highmark Western | $63 | 137% |
| Blue Shield - Pa (Highmark) | $63 | 137% |
| Blue Shield - Wa (Regence) | $63 | 137% |
| Health Choices | $63 - $130 | 137% |
| Kaiser Domestic | $63 | 137% |
| U Of M Health Plan | $70 | 152% |
| Health Cost Solutions | $71 | 154% |
| Vitalcore | $71 | 154% |
| Wellpath | $71 | 154% |
| Priority Health | $75 - $83 | 163% |
| Acs Benefit Services | $87 | 189% |
| Allied Benefit Systems | $87 | 189% |
| Claimchoice Adminstrators | $87 | 189% |
| Consociate | $87 | 189% |
| Cypress Benefit Administrators | $87 | 189% |
| Forest County Potawatomi | $87 | 189% |
| Health Smart | $87 | 189% |
| Healthgram | $87 | 189% |
| Healthscope | $87 | 189% |
| Secureone Preferred United Plans | $87 | 189% |
| Sisco Benefits | $87 | 189% |
| The Health Plan | $87 | 189% |
| Trustmark Small Business Benefits | $87 | 189% |
| Unified Group Services | $87 | 189% |
| Webtpa | $87 | 189% |
| Employee Benefit Logistic | $102 | 221% |
| Asr Health Benefits | $106 | 230% |
| Caresource | $106 | 230% |
| Hap | $106 - $125 | 230% |
| Varipro | $106 | 230% |
| Geha | $118 - $131 | 256% |
| Luminare Health (Detroit) | $118 | 256% |
| Meritain | $118 | 256% |
| Health Partners | $125 | 271% |
| Tufts Health Plan | $125 | 271% |
| Cigna | $128 - $163 | 278% |
| Access Health | $130 | 282% |
| Acclaim | $130 | 282% |
| Administrative Concepts | $130 | 282% |
| Allegeant | $130 | 282% |
| Ameriben | $130 | 282% |
| American Family | $130 | 282% |
| American Healthcare Alliance | $130 | 282% |
| American National | $130 | 282% |
| American Republic | $130 | 282% |
| Amerihealth | $130 | 282% |
| Aultcare | $130 | 282% |
| Automated Benefit Services | $130 | 282% |
| Auxiant | $130 | 282% |
| Benefit Administrative Systems,Llc | $130 | 282% |
| Boon Chapman | $130 | 282% |
| Cam Administrative Services | $130 | 282% |
| Christian Brother Services | $130 | 282% |
| Christian Brothers Holy Cross | $130 | 282% |
| Comprehensive Benefits | $130 | 282% |
| Continental Life Insurance | $130 | 282% |
| Custom Benefit Administrators | $130 | 282% |
| Employee Benefit Concepts | $130 | 282% |
| Employee Benefit Management | $130 | 282% |
| Enterprise Group Planning | $130 | 282% |
| Freedom Life Insurance Company | $130 | 282% |
| Group Administrators | $130 | 282% |
| Group Marketing Services | $130 | 282% |
| Guardian | $130 | 282% |
| Health America | $130 | 282% |
| Healthcare Management Admin | $130 | 282% |
| Healthez | $130 | 282% |
| Humana | $130 | 282% |
| Insight | $130 | 282% |
| Intercare | $130 | 282% |
| Jfp Benefit Management | $130 | 282% |
| Jp Farley Corporation | $130 | 282% |
| Key Benefit Administrator | $130 | 282% |
| Liberty Union Life Assurance Co | $130 | 282% |
| Lucent Health | $130 | 282% |
| Luminare Health | $130 | 282% |
| Magnacare | $130 | 282% |
| Medben | $130 | 282% |
| Medcost | $130 | 282% |
| Medical Mutual | $130 | 282% |
| Mutual Health Services | $130 | 282% |
| Mutual Of Omaha | $130 | 282% |
| Ncas | $130 | 282% |
| Nippon Life Ins | $130 | 282% |
| Nova | $130 | 282% |
| Painters Union Insurance Fund | $130 | 282% |
| Physicians Mutual | $130 | 282% |
| Plumbers Local 98 Insurance Fund | $130 | 282% |
| Prairie States | $130 | 282% |
| Preferred One | $130 | 282% |
| Primary Physician Care | $130 | 282% |
| Professional Benefit Administrators | $130 | 282% |
| Siho Insurance Services | $130 | 282% |
| The Loomis Company | $130 | 282% |
| Unicare | $130 | 282% |
| Us Health And Life | $130 | 282% |
| Valenz | $130 | 282% |
| Western & Southern Financial Group | $130 | 282% |
| Wps | $130 | 282% |
| 1199 National Benefit Fund | $131 | 284% |
| Allied National Global Care | $131 | 284% |
| Asrm - Reliance Standard Life Insurance | $131 | 284% |
| Christian Care Ministry | $131 | 284% |
| Dean Health | $131 | 284% |
| Fallon Health | $131 | 284% |
| Family Life Insurance Company | $131 | 284% |
| Ghc Scw | $131 | 284% |
| Group Pension Administrators | $131 | 284% |
| International Benefit Administrators | $131 | 284% |
| Lifetime Benefit Solutions | $131 | 284% |
| Manhattan Life | $131 | 284% |
| Medi Share | $131 | 284% |
| Multiplan | $131 | 284% |
| Mvp | $131 | 284% |
| Pai | $131 | 284% |
| Pan-American Life | $131 | 284% |
| Paramount Hmo | $131 | 284% |
| Phcs | $131 | 284% |
| Trinity Health Share | $131 | 284% |
| First Health | $133 | 289% |
| Coventry | $163 | 354% |
| Prime Health Services | $163 | 354% |
| Three Rivers Provider Network | $184 | 399% |
| Carelon Behavioral Health | $204 | 443% |
| Cmh Detroit Wayne Integrated Health Network | $204 | 443% |
| Cmh Lenawee County | $204 | 443% |
| Cmh Livingston County | $204 | 443% |
| Cmh Misc | $204 | 443% |
| Cmh Monroe County | $204 | 443% |
| Cmh Washtenaw County | $204 | 443% |
| Magellan Behavioral Health | $204 | 443% |