CMS Price Transparency Data

Orthotic fitting and training

Facility: Metropolitan Hospital Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $194
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.21x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Metropolitan Hospital Center is $194. 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 4.21x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$194

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: $194 (421%)
Ins. Median: $194 (421% 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 421% of the Medicare baseline (a markup of 321%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $23 - $257 50%
Local 1199 $33 - $254 72%
Healthfirst $43 - $221 93%
Wellcare $57 124%
Fidelis $77 - $221 167%
Metroplus $90 - $221 195%
Amidacare $98 213%
Blue Cross Blue Shield $98 - $239 213%
Carelon $98 - $194 213%
Senior Whole Health $98 213%
United $98 - $504 213%
United Behavioral Health $98 - $108 213%
Affinity $100 - $221 217%
Carelon (Amida Care) $100 217%
Vnsny $100 - $254 217%
Emblem $147 - $319 319%
Centerlight $149 323%
Elderplan $194 421%
Villagecare Max $209 - $254 453%
Magnacare $224 - $320 486%
Oxford $236 - $410 512%
Multiplan $239 519%
Cigna $241 523%
Oscar $251 - $614 545%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals