CMS Price Transparency Data

Orthotic fitting and training

Facility: Saratoga Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $98
Cash Discount Price: $58
vs. Medicare Baseline: 2.13x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Saratoga Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.13x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $58 (126%)

Insurance Median: $98 (213%)

Cash: $58 (126% of Medicare)

Ins. Median: $98 (213% 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 213% of the Medicare baseline (a markup of 113%). 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	$20 - $206	43%
Blue Cross Blue Shield	$55 - $181	119%
Cdphp	$60 - $220	130%
Emblem	$60 - $80	130%
Fidelis	$60 - $220	130%
Empire Plan Nyship	$69 - $80	150%
Mvp Commercial	$80 - $215	174%
Hamaspik	$82 - $229	178%
Multiplan	$86 - $98	187%
Mvp Essential Plan	$98 - $195	213%
Mvp Govt Programs	$98	213%
UnitedHealthcare	$98 - $104	213%
Magnacare	$104 - $109	226%
Blue Shield	$115 - $256	250%

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 $58.
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 Saratoga Hospital 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.