CMS Price Transparency Data
Orthotic fitting and training
Facility: Mount Carmel St Ann's
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $71
- Cash Discount Price: $99
- vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mount Carmel St Ann's is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.54x the Medicare baseline. Located in 500 South Cleveland Avenue, Westerville, OH.
Cash / Self-Pay
$99
Average discount available for prompt cash payment at this facility.
Insurance Median
$71
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: $99 (215%)
Insurance Median: $71 (154%)
Cash: $99 (215% of Medicare)
Ins. Median: $71 (154% 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.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $38 - $46 | 82% |
| Aetna | $43 - $153 | 93% |
| Blue Cross Blue Shield | $43 - $153 | 93% |
| UnitedHealthcare | $44 - $283 | 95% |
| The Health Plan | $45 - $101 | 98% |
| Blue Benefit Administrators Of Massachusetts | $57 | 124% |
| Blue Care Network | $57 | 124% |
| Blue Distinction Transplant | $57 | 124% |
| Blue Shield - Ca | $57 | 124% |
| Blue Shield - Id (Regence) | $57 | 124% |
| Blue Shield - Ny Highmark Northeastern | $57 | 124% |
| Blue Shield - Ny Highmark Western | $57 | 124% |
| Blue Shield - Pa (Highmark) | $57 | 124% |
| Blue Shield - Wa (Regence) | $57 | 124% |
| Geha | $69 - $283 | 150% |
| Gravie Admin Services | $69 | 150% |
| Healthez | $69 | 150% |
| Meritain | $69 | 150% |
| Webtpa | $69 | 150% |
| Access Health | $71 | 154% |
| Acclaim | $71 | 154% |
| Administrative Concepts | $71 | 154% |
| Allegeant | $71 | 154% |
| Allied Benefit Systems | $71 | 154% |
| American Family | $71 | 154% |
| American Healthcare Alliance | $71 | 154% |
| American National | $71 | 154% |
| American Republic | $71 | 154% |
| Amerihealth | $71 | 154% |
| Aultcare | $71 | 154% |
| Automated Benefit Services | $71 | 154% |
| Auxiant | $71 | 154% |
| Benefit Administrative Systems,Llc | $71 | 154% |
| Boon Chapman | $71 | 154% |
| Cam Administrative Services | $71 | 154% |
| Christian Brother Services | $71 | 154% |
| Christian Brothers Holy Cross | $71 | 154% |
| Claimchoice Adminstrators | $71 | 154% |
| Comprehensive Benefits | $71 | 154% |
| Continental Life Insurance | $71 | 154% |
| Coventry | $71 | 154% |
| Custom Benefit Administrators | $71 | 154% |
| Cypress Benefit Administrators | $71 | 154% |
| Employee Benefit Concepts | $71 | 154% |
| Employee Benefit Management | $71 | 154% |
| Forest County Potawatomi | $71 | 154% |
| Freedom Life Insurance Company | $71 | 154% |
| Group Administrators | $71 | 154% |
| Group Marketing Services | $71 | 154% |
| Group Pension Administrators | $71 | 154% |
| Guardian | $71 | 154% |
| Health America | $71 | 154% |
| Health Choices | $71 | 154% |
| Healthcare Management Admin | $71 | 154% |
| Insight | $71 | 154% |
| Intercare | $71 | 154% |
| Jfp Benefit Management | $71 | 154% |
| Jp Farley Corporation | $71 | 154% |
| Key Benefit Administrator | $71 | 154% |
| Liberty Union Life Assurance Co | $71 | 154% |
| Lucent Health | $71 | 154% |
| Luminare Health | $71 | 154% |
| Magnacare | $71 | 154% |
| Medcost | $71 | 154% |
| Mutual Health Services | $71 | 154% |
| Mutual Of Omaha | $71 | 154% |
| Ncas | $71 | 154% |
| Nippon Life Ins | $71 | 154% |
| Nova | $71 | 154% |
| Painters Union Insurance Fund | $71 | 154% |
| Physicians Mutual | $71 | 154% |
| Plumbers Local 98 Insurance Fund | $71 | 154% |
| Prairie States | $71 | 154% |
| Preferred One | $71 | 154% |
| Primary Physician Care | $71 | 154% |
| Professional Benefit Administrators | $71 | 154% |
| Secureone Preferred United Plans | $71 | 154% |
| Siho Insurance Services | $71 | 154% |
| Sisco Benefits | $71 | 154% |
| The Loomis Company | $71 | 154% |
| Trustmark Small Business Benefits | $71 | 154% |
| U Of M Health Plan | $71 | 154% |
| Unicare | $71 | 154% |
| Unified Group Services | $71 | 154% |
| Us Health And Life | $71 | 154% |
| Valenz | $71 | 154% |
| Varipro | $71 | 154% |
| Wps | $71 | 154% |
| Hospice Mount Carmel | $72 | 156% |
| Oscar | $72 | 156% |
| Humana | $78 - $153 | 169% |
| Medical Mutual | $80 - $121 | 174% |
| First Health | $81 | 176% |
| Paramount Hmo | $81 | 176% |
| Enterprise Group Planning | $85 | 184% |
| Rural Carrier Health Benefit Plan | $87 | 189% |
| Custom Design Benefits | $92 | 200% |
| Medben | $92 - $115 | 200% |
| Consociate | $93 | 202% |
| Health Ohio Network | $93 | 202% |
| Quality Care Partners | $99 | 215% |
| Caresource | $112 | 243% |
| Healthlink Inc | $115 | 250% |
| Medical Benefits Mutual | $115 | 250% |
| Ohio Health Choice | $115 | 250% |
| Ohio Ppo Connect | $115 | 250% |
| Western & Southern Financial Group | $115 | 250% |
| Ameriben | $122 | 265% |
| Luminare Health (Detroit) | $122 | 265% |
| Medi Share | $122 | 265% |
| Multiplan | $122 | 265% |
| Ohiohealthy | $122 | 265% |
| Osu Not Independent Choice | $122 | 265% |
| Phcs | $122 | 265% |
| Philadelphia American Life Insurance | $122 | 265% |
| Twin Valley Psychiatric | $122 | 265% |
| Health Smart | $130 | 282% |
| Bccp | $153 | 332% |
| Medicaid / KanCare | $153 | 332% |
| Optima Health | $153 | 332% |
| American Postal Workers Secondary | $232 | 503% |
| Cigna | $232 | 503% |
| Health Partners | $232 | 503% |
| Healthgram | $232 | 503% |
| Mvp | $232 | 503% |
| Priority Health | $232 | 503% |
| Crime Victim Assistance | $632 | 1371% |
| Ohio Safe Program | $632 | 1371% |