CMS Price Transparency Data

Orthotic fitting and training

Facility: The Outer Banks Hospital, Inc

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $58
Cash Discount Price: $50
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at The Outer Banks Hospital, Inc is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.26x the Medicare baseline. Located in 4800 South Croatan Highway, Nags Head, NC.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $50 (108%)

Insurance Median: $58 (126%)

Cash: $50 (108% of Medicare)

Ins. Median: $58 (126% 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	$28 - $55	61%
Wellcare [1320]	$29	63%
Carolina Complete Health [1317]	$29	63%
Amerihealth McAid Adv [1316]	$30	65%
Liberty Advantage [1313]	$33	72%
UnitedHealthcare	$34 - $53	74%
Humana	$34	74%
Aetna	$35 - $70	76%
Longevity Health [1411]	$41	89%
Nc Dept of Public Safety [1095]	$57	124%
Medcost [1067]	$58 - $61	126%
Cigna	$76 - $86	165%
Multiplan [1031]	$86	187%

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 $50.
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 The Outer Banks 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.