CMS Price Transparency Data

Orthotic fitting and training

Facility: Lodi Community Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $147
Cash Discount Price: $177
vs. Medicare Baseline: 3.19x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Lodi Community Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.19x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.

Cash / Self-Pay

$177

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $177 (384%)

Insurance Median: $147 (319%)

Cash: $177 (384% of Medicare)

Ins. Median: $147 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Blue Cross Blue Shield	$60 - $223	130%
UnitedHealthcare	$60 - $169	130%
Humana	$82	178%
Mmo	$82 - $146	178%
Oscar	$82 - $105	178%
Summacare	$82 - $167	178%
United	$82 - $195	178%
Aetna	$93 - $273	202%
Buckeye	$105	228%
Caresource	$105	228%
The Health Plan	$109 - $218	236%
Molina	$110	239%
Amerihealth	$115	250%
Amish Community Aid Plan	$123 - $136	267%
Ohcp	$133	289%
Aultcare	$136	295%
Omas	$136	295%
Ohio Healthy	$147	319%
Php	$164	356%
Phphi	$164	356%
Upmc	$164	356%
Cigna	$176	382%
Cc Ehp	$183	397%
Gms	$191	414%
Medical Benefit Corp	$191	414%
Consociate Health	$205	445%
Frontpath	$246	534%
Managed Care Services	$246	534%
Multiplan	$246	534%
Tertiary Care Network	$246	534%

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 $177.
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 Lodi Community 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.