CMS Price Transparency Data

Orthotic fitting and training

Facility: Carolina East Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $72
Cash Discount Price: $66
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Carolina East Medical Center is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.56x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $66 (143%)

Insurance Median: $72 (156%)

Cash: $66 (143% of Medicare)

Ins. Median: $72 (156% 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
Pamlico Co Jail-All Plans	$21 - $37	46%
UnitedHealthcare	$28 - $100	61%
Humana	$44	95%
Inclusive Health (Nchirp)-All Plans	$44	95%
Tricare	$44 - $140	95%
Craven Co. Jail Systems - All Plans	$47 - $51	102%
Medcost Ppo Employees And Retirees	$53 - $92	115%
Medcost Ppo Ultra (Employees)	$53 - $88	115%
Blue Cross Blue Shield	$56 - $96	122%
Medcost Ppo City Employees	$58 - $102	126%
Medcost Ppo County Employee	$61 - $106	132%
Benefit Mgmt, Svcs-All Plans	$68 - $119	148%
Aetna	$71 - $124	154%
Medcost Benefit Svc-All Other Plans	$71 - $124	154%
Acs Consult Svc Inc-All Plans	$72 - $126	156%
Medcost Ppo Standard	$72 - $126	156%
Cigna	$73 - $127	158%

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 $66.
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 Carolina East Medical Center 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.