CMS Price Transparency Data

Orthotic fitting and training

Facility: The McDowell Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $47
  • Cash Discount Price: $133
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at The McDowell Hospital is $47. 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 1.02x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.
Cash / Self-Pay
$133

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $47 (102%)
Cash: $133 (289% of Medicare)
Ins. Median: $47 (102% 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.

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 $17 - $18 37%
United $17 - $71 37%
Wellcare $17 - $45 37%
Amerihealth $18 - $19 39%
Partners Health Management $18 - $19 39%
Vaya Health $18 - $19 39%
Apex Health $25 - $28 54%
Alignment Health $39 - $44 85%
Devoted Health $39 - $44 85%
Aetna $40 - $100 87%
Humana $40 - $46 87%
Provider Partners Health Plan $41 - $47 89%
Cigna $42 - $74 91%
Troy Healthcare $42 - $48 91%
Healthteam Advantage $43 - $48 93%
Amerihealth Caritas $44 - $65 95%
Longevity Health Plan $46 - $53 100%
Caresource $56 - $61 122%
Medcost $62 - $117 135%
Magellan $76 - $83 165%
Magellan Behavioral Health $76 - $83 165%
Multiplan $102 - $111 221%
Avalon Administrative Services $108 - $117 234%
Prime Health $112 - $124 243%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 Rankin Drive P O Box 730, Marion, NC 28752
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals