CMS Price Transparency Data

Orthotic fitting and training

Facility: Southern Hills Hospital and Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $46
Cash Discount Price: $360
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Southern Hills Hospital and Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.00x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $360 (781%)

Insurance Median: $46 (100%)

Cash: $360 (781% of Medicare)

Ins. Median: $46 (100% 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
Aetna	$6 - $91	13%
Community Care Health	$34	74%
Molina Healthcare	$34 - $35	74%
Sierra Hpn	$34	74%
Caresource	$35	76%
Ambetter / Centene	$36 - $76	78%
Humana	$39 - $46	85%
Alignment Health Plan	$41 - $46	89%
Blue Cross Blue Shield	$41 - $46	89%
Caremore	$41 - $47	89%
Hometown Health Mcr	$41 - $46	89%
Select Health	$41 - $83	89%
Triwest	$41 - $46	89%
United	$41 - $78	89%
Imperial Nv	$45 - $51	98%
Health Net	$46	100%
Universal Healthcare	$49 - $55	106%
Corvel	$96	208%
Olympus Medsave Usa	$101 - $270	219%
Prominence Healthfirst	$108	234%
Cmn Global	$151	328%
Evernorth	$180	391%
Hometown Health Providers	$180	391%
Nv Health & Welfare Trust	$216	469%
Multiplan	$227 - $263	493%
First Health	$238 - $288	516%
Medcare International	$270	586%

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 $360.
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 Southern Hills Hospital and 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.