CMS Price Transparency Data

Orthotic fitting and training

Facility: Covenant Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $59
Cash Discount Price: $87
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Covenant Medical Center is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.28x the Medicare baseline. Located in 1447 N Harrison, Saginaw, MI.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $87 (189%)

Insurance Median: $59 (128%)

Cash: $87 (189% of Medicare)

Ins. Median: $59 (128% 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 Cross Blue Shield	$23 - $91	50%
Health Advantage Mclaren Employee	$23 - $72	50%
Healthy Michigan Mclaren	$23 - $44	50%
Healthy Michigan Meridian	$23 - $44	50%
Healthy Michigan Molina	$23 - $44	50%
Healthy Michigan Priority Health	$23 - $44	50%
Priority Health E	$23 - $60	50%
Physicians Health Plan	$28 - $72	61%
Priority Health	$28 - $72	61%
Mclaren Health Advantage	$36 - $59	78%
Humana	$38 - $98	82%
Meritain Health	$39 - $100	85%
Aetna	$44 - $96	95%
Blue Care Network	$44 - $91	95%
Health Alliance Plan Of Michigan	$44 - $84	95%
Mclaren Advantage	$44	95%
Molina Healthplan	$44	95%
Physicians Health Plan Advantage/Advantage Plus	$44	95%
Multiplan	$46 - $118	100%
Cigna	$68 - $72	148%

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 $87.
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 Covenant Medical Center 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.