CMS Price Transparency Data

Orthotic fitting and training

Facility: Montefiore St Luke's Cornwall

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $249
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 5.40x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Montefiore St Luke's Cornwall is $249. 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 5.40x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$249

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: $249 (540%)
Ins. Median: $249 (540% 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 540% of the Medicare baseline (a markup of 440%). 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
Healthfirst $49 - $94 106%
Blue Cross Blue Shield $59 - $302 128%
Emblem $59 - $311 128%
Medicaid / KanCare $59 128%
Hamaspik $62 135%
Mvp $75 - $214 163%
Magnacare $118 256%
Oscar $263 571%
Cigna $315 683%
Centivo $356 772%
Northwell $360 781%
American Postal Workers $473 1026%
UnitedHealthcare $473 1026%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 70 Dubois Street, Newburgh, NY 12550
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals