CMS Price Transparency Data

Orthotic fitting and training

Facility: Charlevoix Area Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $111
Cash Discount Price: $121
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Charlevoix Area Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.41x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$121

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $121 (263%)

Insurance Median: $111 (241%)

Cash: $121 (263% of Medicare)

Ins. Median: $111 (241% 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 241% of the Medicare baseline (a markup of 141%). 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	$31 - $143	67%
Mclaren Health Plan	$31 - $144	67%
Meridian	$31	67%
Priority Health	$31 - $155	67%
UnitedHealthcare	$31 - $135	67%
Aetna	$44 - $140	95%
Blue Care Network	$44 - $73	95%
Hap (Health Alliance Plan)	$44 - $124	95%
Medicare (plans)	$44 - $73	95%
Michigan Amish Medical Board	$44 - $73	95%
Molina	$44 - $79	95%
Northern Michigan Mennonite Group	$44 - $73	95%
Provider Network Of America/Hma Group Health	$61 - $132	132%
Asr Physicians Care Network	$65 - $124	141%
Nomi Health	$70 - $144	152%
Employee Benefits Logistics	$74 - $124	161%
Hospice Of Michigan	$78 - $93	169%
Cigna	$85 - $155	184%
Enterprise Group Planning Employee Benefit Plan	$104 - $124	226%
First Health/Coventry Health/Community Care Network	$104 - $124	226%
Medical Cost Savings Solution	$104 - $124	226%
Three Rivers Provider Network	$110 - $132	239%
Iba Health And Life Assurance Company	$120 - $143	260%
Cofinity	$121 - $144	263%
Preferred Medical Claim Solutions	$124 - $147	269%

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 $121.
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 Charlevoix Area 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.