CMS Price Transparency Data

Orthotic fitting and training

Facility: NYU Langone Hospitals

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $266
Cash Discount Price: $87
vs. Medicare Baseline: 5.77x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at NYU Langone Hospitals is $266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 5.77x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$266

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: $87 (189%)

Insurance Median: $266 (577%)

Cash: $87 (189% of Medicare)

Ins. Median: $266 (577% 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 577% of the Medicare baseline (a markup of 477%). 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
1199	$33	72%
Fidelis	$48 - $256	104%
Healthfirst	$48 - $256	104%
Healthplus	$48 - $256	104%
Ghi	$52 - $360	113%
Hip	$52 - $360	113%
Medicare (plans)	$52 - $53	113%
Wellcare	$52 - $53	113%
Amida	$53	115%
Centerlight	$53 - $54	115%
Medicaid / KanCare	$70 - $114	152%
Metroplus	$70 - $256	152%
UnitedHealthcare	$70 - $381	152%
Somos	$73 - $154	158%
Hamaspik	$78 - $80	169%
Oscar	$239	519%
Blue Cross Blue Shield	$262 - $328	568%
Oxford	$308 - $358	668%
Aetna	$313 - $459	679%
Multiplan	$358	777%
Magnacare	$370 - $596	803%
Cigna	$393	853%

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 $87.
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 NYU Langone Hospitals 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.