CMS Price Transparency Data

Orthotic fitting and training

Facility: Mercy Health Rehabilitation Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $193
  • Cash Discount Price: $198
  • vs. Medicare Baseline: 4.19x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Mercy Health Rehabilitation Hospital is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.19x the Medicare baseline. Located in 3180 Belmont Ave, Youngstown, OH.
Cash / Self-Pay
$198

Average discount available for prompt cash payment at this facility.

Insurance Median
$193

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: $198 (430%)
Insurance Median: $193 (419%)
Cash: $198 (430% of Medicare)
Ins. Median: $193 (419% 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 419% of the Medicare baseline (a markup of 319%). 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
Medical Mutual Nas $106 - $111 230%
Aultcare $131 - $138 284%
Multiplan $162 - $170 351%
Aetna $193 - $203 419%
Ambetter / Centene $193 - $203 419%
Blue Cross Blue Shield $193 - $203 419%
Caresource Exchange $193 - $203 419%
Cigna $193 - $203 419%
Devoted $193 - $203 419%
Highmark Ppo Commercial $193 - $203 419%
Highmark Ppo Exchange $193 - $203 419%
Humana $193 - $203 419%
Medicaid / KanCare $193 - $203 419%
Medical Mutual Exchange $193 - $203 419%
Medical Mutual Medflex $193 - $203 419%
Medical Mutual New Biz $193 - $203 419%
Medical Mutual Supermed Commercial $193 - $203 419%
Medical Mutual Traditional Commercial $193 - $203 419%
Medicare (plans) $193 - $203 419%
Molina Exchange $193 - $203 419%
UnitedHealthcare $193 - $203 419%
Upmc $193 - $203 419%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3180 Belmont Ave, Youngstown, OH 44505
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL