CMS Price Transparency Data
Orthotic fitting and training
Facility: Chelsea Hospital
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $136
- Cash Discount Price: $133
- vs. Medicare Baseline: 2.95x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Chelsea Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.95x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$133
Average discount available for prompt cash payment at this facility.
Insurance Median
$136
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: $133 (289%)
Insurance Median: $136 (295%)
Cash: $133 (289% of Medicare)
Ins. Median: $136 (295% 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 295% of the Medicare baseline (a markup of 195%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $25 - $76 | 54% |
| Medicaid / KanCare | $25 | 54% |
| Aetna | $45 - $112 | 98% |
| Arbor Hospice | $45 | 98% |
| Blue Care Network Advantage | $45 | 98% |
| Medicare (plans) | $45 - $46 | 98% |
| Align Senior Care | $46 | 100% |
| Angela Hospice | $46 | 100% |
| Heartland Hospice | $46 | 100% |
| UnitedHealthcare | $47 - $137 | 102% |
| Cca - Zing Health | $48 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $51 | 111% |
| Wc Accident Fund | $54 | 117% |
| Wc Advantage | $54 | 117% |
| Wc Aig | $54 | 117% |
| Wc Allied | $54 | 117% |
| Wc Amerisure | $54 | 117% |
| Wc Amtrust | $54 | 117% |
| Wc Asu Risk Mgt | $54 | 117% |
| Wc Berkley Admin | $54 | 117% |
| Wc Broadspire | $54 | 117% |
| Wc Bunch & Associates | $54 | 117% |
| Wc Ccmsi | $54 | 117% |
| Wc Emc Insurance Company | $54 | 117% |
| Wc Esis | $54 | 117% |
| Wc Fcci | $54 | 117% |
| Wc Federated | $54 | 117% |
| Wc Gallagher Bassett | $54 | 117% |
| Wc Genex Care For Ohio | $54 | 117% |
| Wc Guard Insurance Company | $54 | 117% |
| Wc Hartford | $54 | 117% |
| Wc Liberty Mutual | $54 | 117% |
| Wc Meijers | $54 | 117% |
| Wc Michigan | $54 | 117% |
| Wc Mitchell Frankenmuth | $54 | 117% |
| Wc Pma | $54 | 117% |
| Wc Sedgwick | $54 | 117% |
| Wc Sentry | $54 | 117% |
| Wc Travelers | $54 | 117% |
| Wc Tristar | $54 | 117% |
| Wc Walmart | $54 | 117% |
| Wc Zurich | $54 | 117% |
| Molina Marketplace | $59 | 128% |
| U Of M Health Plan | $70 | 152% |
| Health Cost Solutions | $71 | 154% |
| Vitalcore | $71 | 154% |
| Wellpath | $71 | 154% |
| Bcn Domestic | $76 | 165% |
| Blue Benefit Administrators Of Massachusetts | $76 | 165% |
| Blue Care Network | $76 | 165% |
| Blue Distinction Transplant | $76 | 165% |
| Blue Shield - Ca | $76 | 165% |
| Blue Shield - Id (Regence) | $76 | 165% |
| Blue Shield - Ny Highmark Northeastern | $76 | 165% |
| Blue Shield - Ny Highmark Western | $76 | 165% |
| Blue Shield - Pa (Highmark) | $76 | 165% |
| Blue Shield - Wa (Regence) | $76 | 165% |
| Health Choices | $76 - $136 | 165% |
| Kaiser Domestic | $76 | 165% |
| Priority Health | $79 - $88 | 171% |
| Asr Health Benefits | $97 | 210% |
| Caresource | $97 | 210% |
| Hap | $97 - $158 | 210% |
| Varipro | $97 | 210% |
| Employee Benefit Logistic | $102 | 221% |
| Geha | $112 - $137 | 243% |
| Meritain | $112 | 243% |
| Access Health | $136 | 295% |
| Acclaim | $136 | 295% |
| Administrative Concepts | $136 | 295% |
| Allegeant | $136 | 295% |
| Ameriben | $136 | 295% |
| American Family | $136 | 295% |
| American Healthcare Alliance | $136 | 295% |
| American National | $136 | 295% |
| American Republic | $136 | 295% |
| Amerihealth | $136 | 295% |
| Aultcare | $136 | 295% |
| Automated Benefit Services | $136 | 295% |
| Auxiant | $136 | 295% |
| Benefit Administrative Systems,Llc | $136 | 295% |
| Boon Chapman | $136 | 295% |
| Cam Administrative Services | $136 | 295% |
| Christian Brother Services | $136 | 295% |
| Christian Brothers Holy Cross | $136 | 295% |
| Comprehensive Benefits | $136 | 295% |
| Continental Life Insurance | $136 | 295% |
| Custom Benefit Administrators | $136 | 295% |
| Employee Benefit Concepts | $136 | 295% |
| Employee Benefit Management | $136 | 295% |
| Enterprise Group Planning | $136 | 295% |
| Freedom Life Insurance Company | $136 | 295% |
| Group Administrators | $136 | 295% |
| Group Marketing Services | $136 | 295% |
| Guardian | $136 | 295% |
| Health America | $136 | 295% |
| Healthcare Management Admin | $136 | 295% |
| Healthez | $136 | 295% |
| Humana | $136 | 295% |
| Insight | $136 | 295% |
| Intercare | $136 | 295% |
| Jfp Benefit Management | $136 | 295% |
| Jp Farley Corporation | $136 | 295% |
| Key Benefit Administrator | $136 | 295% |
| Liberty Union Life Assurance Co | $136 | 295% |
| Lucent Health | $136 | 295% |
| Luminare Health | $136 | 295% |
| Luminare Health (Detroit) | $136 | 295% |
| Magnacare | $136 | 295% |
| Medben | $136 | 295% |
| Medcost | $136 | 295% |
| Medical Mutual | $136 | 295% |
| Mutual Health Services | $136 | 295% |
| Mutual Of Omaha | $136 | 295% |
| Ncas | $136 | 295% |
| Nippon Life Ins | $136 | 295% |
| Nova | $136 | 295% |
| Painters Union Insurance Fund | $136 | 295% |
| Physicians Mutual | $136 | 295% |
| Plumbers Local 98 Insurance Fund | $136 | 295% |
| Prairie States | $136 | 295% |
| Preferred One | $136 | 295% |
| Primary Physician Care | $136 | 295% |
| Professional Benefit Administrators | $136 | 295% |
| Siho Insurance Services | $136 | 295% |
| Sisco Benefits | $136 | 295% |
| The Loomis Company | $136 | 295% |
| Unicare | $136 | 295% |
| Us Health And Life | $136 | 295% |
| Valenz | $136 | 295% |
| Western & Southern Financial Group | $136 | 295% |
| Wps | $136 | 295% |
| Coventry | $139 | 302% |
| First Health | $139 | 302% |
| Hospice Of Michigan | $143 | 310% |
| Cigna | $144 | 312% |
| 1199 National Benefit Fund | $153 | 332% |
| Allied National Global Care | $153 | 332% |
| Asrm - Reliance Standard Life Insurance | $153 | 332% |
| Christian Care Ministry | $153 | 332% |
| Dean Health | $153 | 332% |
| Fallon Health | $153 | 332% |
| Family Life Insurance Company | $153 | 332% |
| Ghc Scw | $153 | 332% |
| Group Pension Administrators | $153 | 332% |
| International Benefit Administrators | $153 | 332% |
| Lifetime Benefit Solutions | $153 | 332% |
| Manhattan Life | $153 | 332% |
| Medi Share | $153 | 332% |
| Multiplan | $153 | 332% |
| Mvp | $153 | 332% |
| Pai | $153 | 332% |
| Pan-American Life | $153 | 332% |
| Paramount Hmo | $153 | 332% |
| Phcs | $153 | 332% |
| Trinity Health Share | $153 | 332% |
| Health Partners | $158 | 343% |
| Tufts Health Plan | $158 | 343% |
| Prime Health Services | $163 | 354% |
| Three Rivers Provider Network | $184 | 399% |
| Cmh Detroit Wayne Integrated Health Network | $204 | 443% |
| Cmh Jackson County/Lifeways | $204 | 443% |
| Cmh Lenawee County | $204 | 443% |
| Cmh Livingston County | $204 | 443% |
| Cmh Misc | $204 | 443% |
| Cmh Monroe County | $204 | 443% |
| Cmh Washtenaw County | $204 | 443% |
| Magellan Behavioral Health | $204 | 443% |