CMS Price Transparency Data

Orthotic fitting and training

Facility: University of Michigan Health System

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $153
Cash Discount Price: $86
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at University of Michigan Health System is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.32x the Medicare baseline. Located in 1500 E Medical Center Drive, Spc 5474, Ann Arbor, MI.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$153

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: $86 (187%)

Insurance Median: $153 (332%)

Cash: $86 (187% of Medicare)

Ins. Median: $153 (332% 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 332% of the Medicare baseline (a markup of 232%). 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
Point Comfort Underwriters Unaccompanied Children Program	$92 - $94	200%
Priority Health [1038]	$98 - $142	213%
Metrocare	$101 - $102	219%
Medicaid / KanCare	$107 - $109	232%
UnitedHealthcare	$111 - $159	241%
Hap [1023]	$117 - $164	254%
Aetna	$123 - $153	267%
Confinity Advantage	$123 - $126	267%
Plain Church Group	$128 - $131	278%
Beaumont Health Network	$150 - $153	325%
Mclaren Health Plan Inc	$150 - $152	325%
Nomi Health	$150 - $153	325%
Provider Network Of America	$150 - $153	325%
First Agency	$160 - $164	347%
Parkview Health Plan Services	$160 - $164	347%
Cofinity	$163 - $166	354%
Paramount Health Care	$178 - $181	386%
Bronson Healthcare Group	$182 - $185	395%
First Health	$182 - $185	395%
Multiplan	$182 - $185	395%
Blue Care Network Of Michigan	$201	436%
Blue Cross Blue Shield	$201	436%
Priority Health	$227 - $232	493%

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 $86.
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 University of Michigan Health System 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.