CMS Price Transparency Data

Orthotic fitting and training

Facility: Transylvania Regional Hospital, Inc

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $71
Cash Discount Price: $174
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Transylvania Regional Hospital, Inc is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.54x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.

Cash / Self-Pay

$174

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $174 (378%)

Insurance Median: $71 (154%)

Cash: $174 (378% of Medicare)

Ins. Median: $71 (154% 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
Blue Cross Blue Shield	$33 - $35	72%
United	$33 - $78	72%
Amerihealth	$34	74%
Partners Health Management	$34	74%
Vaya Health	$34	74%
Wellcare	$34	74%
Apex Health	$35	76%
Aetna	$45 - $125	98%
Cigna	$64 - $88	139%
Amerihealth Caritas	$71	154%
Caresource	$76	165%
Medcost	$97 - $148	210%
Magellan	$104	226%
Magellan Behavioral Health	$104	226%
Multiplan	$139	302%
Avalon Administrative Services	$148	321%
Prime Health	$153 - $156	332%

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 $174.
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 Transylvania Regional Hospital, Inc 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.