CMS Price Transparency Data

Orthotic fitting and training

Facility: Atrium Health Cleveland

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $66
Cash Discount Price: $76
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Atrium Health Cleveland is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.43x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $76 (165%)

Insurance Median: $66 (143%)

Cash: $76 (165% of Medicare)

Ins. Median: $66 (143% 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
Amerihealth Caritas	$21 - $26	46%
Partners	$21 - $26	46%
Alliance	$22 - $26	48%
Carolina Complete Health	$22 - $26	48%
Healthy Blue	$22 - $26	48%
Trillium	$22 - $26	48%
Vaya	$22 - $26	48%
Wellcare	$22 - $26	48%
UnitedHealthcare	$26 - $81	56%
Aetna	$40 - $117	87%
Cigna	$44 - $121	95%
Humana	$45	98%
Blue Cross Blue Shield	$47 - $62	102%
Ambetter / Centene	$48 - $55	104%
Employers Health Network	$67	145%
Physician Reach Out	$76	165%
Medcost	$85 - $100	184%
Magellan	$91	197%
Gmmi	$99	215%
Quik Trip	$99	215%
Carolina Behavioral Health	$109 - $121	236%
Healthgram	$121	263%
Choicecare	$124	269%
First Health	$129	280%
Lifesynch Community Choice Care	$129	280%
Private Health Care Systems	$136	295%
Beechstreet	$139	302%
Multiplan	$144	312%

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 $76.
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 Atrium Health Cleveland 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.