CMS Price Transparency Data

Orthotic fitting and training

Facility: Ocean Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $182
Cash Discount Price: $60
vs. Medicare Baseline: 3.95x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Ocean Medical Center is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.95x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$60

Average discount available for prompt cash payment at this facility.

Insurance Median

$182

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: $60 (130%)

Insurance Median: $182 (395%)

Cash: $60 (130% of Medicare)

Ins. Median: $182 (395% 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 395% of the Medicare baseline (a markup of 295%). 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
Aetna	$36 - $196	78%
Clover	$37 - $45	80%
Seoul Medical Group	$44 - $48	95%
Amerigroup	$45 - $60	98%
Horizon	$60 - $206	130%
Vaccn	$60	130%
United Community/Americhoice	$63	137%
UnitedHealthcare	$70 - $565	152%
Karna	$80 - $83	174%
Cigna	$103 - $239	223%
Blue Cross Blue Shield	$104	226%
Horizon - Jri@Oumc	$116 - $205	252%
Activecare First McO	$144 - $212	312%
Intergroup	$144	312%
Prime Health	$165	358%
Multiplan - PHCS	$175 - $212	380%
Oxford - Jri@Oumc	$193	419%
Qualcare	$194 - $306	421%
Amerihealth	$204 - $243	443%
Wellcare	$224	486%
Brighton Health Plan	$225 - $525	488%
Bergen Risk	$325	705%
Oxford	$414 - $455	898%
Brighton Health Plan - Jri@Oumc	$500	1085%

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 $60.
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 Ocean 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.