CMS Price Transparency Data

Orthotic fitting and training

Facility: Cheshire Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $96
Cash Discount Price: $59
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Cheshire Medical Center is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.08x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $59 (128%)

Insurance Median: $96 (208%)

Cash: $59 (128% of Medicare)

Ins. Median: $96 (208% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 208% of the Medicare baseline (a markup of 108%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 Nh	$19 - $26	41%
Granite State Health Plan	$19 - $36	41%
Wellsense Health Plan	$19 - $51	41%
Mass General Brigham Health Plan	$40 - $214	87%
Harvard Pilgrim Health Care Of Ne	$46 - $97	100%
Aetna	$47 - $146	102%
Ambetter / Centene	$47 - $51	102%
Blue Cross Blue Shield	$47 - $195	102%
Cigna	$47 - $122	102%
Martin'S Point Generations Advantage	$47 - $51	102%
Mvp	$47 - $122	102%
UnitedHealthcare	$47 - $162	102%
Wellcare Health Plans	$47 - $51	102%
Martin'S Point Health Care	$49 - $51	106%
Maine Community Health Options	$96	208%
Tufts Health Plan	$137 - $142	297%
First Health/Hcvm	$182	395%
Phcs	$193	419%

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 $59.
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 Cheshire 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.