CMS Price Transparency Data

Orthotic fitting and training

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $43
Cash Discount Price: $64
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Ascension Providence Hospital, Southfield and Novi is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.93x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $64 (139%)

Insurance Median: $43 (93%)

Cash: $64 (139% of Medicare)

Ins. Median: $43 (93% 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
Blue Caid Michigan	$25	54%
Harbor Health Mcd	$25	54%
Medicaid / KanCare	$25 - $43	54%
Molina Health	$25	54%
Total Health Care	$25	54%
UnitedHealthcare	$25	54%
Amerihealth Vip Care Mcr	$37 - $43	80%
Hap Alliance Health	$41	89%
Hap Hmo Pos	$41	89%
Aetna	$43	93%
Auto Insurance	$43	93%
Jvhl - Mcr Replacement	$43	93%
Mcr Replacement	$43	93%
Veterans Choice	$43	93%
Humana	$44	95%
Meridian Wellcare	$46	100%
Molina Advantage	$46	100%
Hap Preferred	$49	106%
Ambetter / Centene	$54	117%
Molina Marketplace	$54	117%
Smart Health	$60	130%
Bc Metro Detroit Epo	$101	219%
Bc Metro Detroit Hmo	$101	219%
Bcn Local Network Southeast	$101 - $102	219%
Blue Care Network	$101	219%
Blue Cross Blue Shield	$101	219%

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 $64.
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 Ascension Providence Hospital, Southfield and Novi 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.