CMS Price Transparency Data

Orthotic fitting and training

Facility: Montefiore Mount Vernon Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $77
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Montefiore Mount Vernon Hospital is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.67x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$77

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%)
Insurance Median: $77 (167%)
Ins. Median: $77 (167% 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.

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
American Postal Workers $50 108%
UnitedHealthcare $50 - $77 108%
Healthfirst $52 - $125 113%
Metroplus $52 - $138 113%
Blue Cross Blue Shield $53 - $173 115%
Emblem $53 - $284 115%
Fidelis $53 - $134 115%
Point Comfort $53 115%
Villagecaremax $53 115%
Vnsny Choice $53 - $88 115%
Wellcare $54 - $78 117%
Humana $58 126%
Longevity $58 126%
Molina Healthcare Of Ny Affinity $73 - $173 158%
Amidacare $77 167%
Medicaid / KanCare $77 167%
Mvp $77 - $176 167%
Hamaspik $81 - $83 176%
Vnsny Select Health $88 191%
Cigna $284 - $315 616%
Northwell $394 855%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals