CMS Price Transparency Data

Orthotic fitting and training

Facility: Ira Davenport Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $96
Cash Discount Price: $128
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Ira Davenport Memorial Hospital is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.08x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $128 (278%)

Insurance Median: $96 (208%)

Cash: $128 (278% of Medicare)

Ins. Median: $96 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Empire	$16	35%
Blue Cross Blue Shield	$44 - $481	95%
Humana	$44 - $143	95%
Tricare	$44	95%
Amerihealth Caritas Mcr Adv - All Plans	$45	98%
Fidelis	$56 - $64	122%
Fidelis Care - Exchange - All Plans	$70 - $87	152%
Geisinger - All Plans	$74 - $92	161%
Cigna	$80 - $99	174%
Mvp Health Plan - All Plans	$80 - $99	174%
Independent Health - All Plans	$83 - $103	180%
Upmc - All Plans	$88 - $109	191%
Pomco Inc - All Plans	$92 - $114	200%
Aetna	$96 - $119	208%
UnitedHealthcare	$96 - $134	208%
Emblem Health - All Plans	$112 - $139	243%
Emblem/Ghi	$118	256%
Martins Point - All Plans	$128 - $159	278%
Healthnow - All Plans	$421 - $522	913%

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 $128.
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 Ira Davenport Memorial 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.