CMS Price Transparency Data

Orthotic fitting and training

Facility: University of Michigan Health - West

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $126
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at University of Michigan Health - West is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.73x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $70 (152%)
Insurance Median: $126 (273%)
Cash: $70 (152% of Medicare)
Ins. Median: $126 (273% 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 273% of the Medicare baseline (a markup of 173%). 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
Priority Health $77 167%
Web Tpa $77 167%
Aetna $117 254%
Alliance Health & Life Ppo $117 254%
Asr Physicians $117 254%
Hap $117 254%
Golden Rule Ins $126 273%
Medica $126 273%
Student Ins/Mega Life $126 273%
UnitedHealthcare $126 273%
Humana $131 284%
Asr Cofinity $146 317%
Cofinity Commercial $146 317%
Cofinity Weyco $146 317%
Core Source $146 317%
Epoch Group $146 317%
Health Partners $146 317%
Hlthcomp Admin $146 317%
Mid America $146 317%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 Byron Center Avenue, Sw, Wyoming, MI 49519
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals