CMS Price Transparency Data

Orthotic fitting and training

Facility: Lancaster General Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $91
  • Cash Discount Price: $110
  • vs. Medicare Baseline: 1.97x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Lancaster General Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.97x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$110

Average discount available for prompt cash payment at this facility.

Insurance Median
$91

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: $110 (239%)
Insurance Median: $91 (197%)
Cash: $110 (239% of Medicare)
Ins. Median: $91 (197% 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

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
Blue Cross Blue Shield $16 - $405 35%
Hospice And Community Care $21 46%
Upmc For You $27 - $28 59%
Old Order Group $29 - $36 63%
Lg Coresource/Lg Eliance $31 - $32 67%
UnitedHealthcare $31 - $94 67%
Medicaid / KanCare $32 - $85 69%
Lancashire Hall $33 - $111 72%
Nursing Home Op Services $33 72%
Tricare $39 85%
Highmark $43 - $111 93%
Aetna $44 - $75 95%
Affilia Home Health $44 - $111 95%
Albright Life $44 95%
Coatesville Va $44 95%
Hospice Generic $44 95%
Lebanon Veterans Hospital $44 95%
Medicare (plans) $44 - $48 95%
Amerihealth Caritas $45 98%
Cigna $45 - $93 98%
Health Partners Mcr Advantage $45 98%
Devoted Health $46 100%
Masonic Homes $46 - $111 100%
Pa Health And Wellness Mcr $46 100%
Gateway $54 - $56 117%
Elap Employees $62 135%
Eliance Health Solutions $70 - $71 152%
Highmark Commercial Preferred $73 - $111 158%
Oscar Health Plan $85 184%
Ehp $89 - $91 193%
Upmc Commercial $89 - $94 193%
Devon $93 - $94 202%
Geisinger Commercial $93 - $94 202%
Intergroup Services $93 - $94 202%
Preferred Healthcare $93 - $94 202%
Medi-Share Christian Care $104 - $105 226%
Commercial Generic $109 - $111 236%
Highmark Commercial Non-Preferred $109 - $112 236%
Magellan $109 - $111 236%
United Behavioral Health $109 - $111 236%
Value Options $109 - $111 236%
Workers Compensation $109 - $111 236%
Claim Watcher Plus $131 284%
Claim Watcher $144 312%
Elap Other Groups $159 345%
Gift Of Life Donor Program $13,500 29291%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals