CMS Price Transparency Data

Orthotic fitting and training

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $104
Cash Discount Price: $128
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Munson Healthcare Otsego Memorial Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.26x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $128 (278%)

Insurance Median: $104 (226%)

Cash: $128 (278% of Medicare)

Ins. Median: $104 (226% 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 226% of the Medicare baseline (a markup of 126%). 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
Blue Cross Blue Shield	$23 - $97	50%
Mclaren Health Plan	$23 - $131	50%
Meridian	$23	50%
Molina	$23 - $47	50%
Priority Health	$23 - $93	50%
UnitedHealthcare	$23 - $125	50%
Aetna	$44 - $126	95%
Blue Care Network	$44	95%
Hap (Health Alliance Plan)	$44 - $125	95%
Humana	$44	95%
Medicare (plans)	$44	95%
Michigan Amish Medical Board	$44	95%
Northern Michigan Mennonite Group	$44	95%
Asr Physicians Care Network	$65 - $125	141%
Nomi Health	$70 - $125	152%
Employee Benefit Logistics	$74	161%
Hospice Of Michigan	$78 - $94	169%
Cigna	$85 - $93	184%
Munson Hospice	$91 - $852	197%
Enterprise Group Planning/Employee Benefit Plan	$104 - $125	226%
Cofinity	$110 - $133	239%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$110 - $133	239%
Three Rivers Provider Network	$110 - $133	239%

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 $128.
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 Munson Healthcare Otsego Memorial Hospital 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.