CMS Price Transparency Data
Orthotic fitting and training
Facility: Hospital of Univ of Pennsylvania
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $65
- Cash Discount Price: $276
- vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Hospital of Univ of Pennsylvania is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $276. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.41x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$276
Average discount available for prompt cash payment at this facility.
Insurance Median
$65
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: $276 (599%)
Insurance Median: $65 (141%)
Cash: $276 (599% of Medicare)
Ins. Median: $65 (141% 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 |
|---|---|---|
| Paired Kidney Exchange | $10 - $78 | 22% |
| Horizon Nj Health | $11 - $85 | 24% |
| Keystone Mercy Health Plan | $13 - $486 | 28% |
| Preferred Health Care Eliance | $14 - $107 | 30% |
| Pgm - Regie De L'Assurance Maladie Quebec | $15 - $112 | 33% |
| Upmc | $16 - $486 | 35% |
| Blue Cross Blue Shield | $18 - $296 | 39% |
| Cigna | $23 - $219 | 50% |
| Pgm - Kuwait Defense | $23 - $219 | 50% |
| Aetna | $24 - $486 | 52% |
| Gspp And Wissahickon Hospice | $24 | 52% |
| Qualcare | $25 - $185 | 54% |
| Coventry | $26 - $248 | 56% |
| Medicaid / KanCare | $26 - $486 | 56% |
| Olympus | $26 - $191 | 56% |
| Pgm - Chop | $26 - $194 | 56% |
| Wissahickon Hospice | $26 - $194 | 56% |
| Healthamerica/Coventry | $29 - $238 | 63% |
| First Health Global | $32 - $243 | 69% |
| Health Partners | $32 - $486 | 69% |
| Health Net | $39 - $292 | 85% |
| Kaiser Permanente | $39 - $486 | 85% |
| Pgm - Royal Embassy Of Saudi Arabia | $39 - $292 | 85% |
| Pgm - Embassy Of Qatar | $42 - $316 | 91% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $42 - $316 | 91% |
| UnitedHealthcare | $42 - $486 | 91% |
| Interlink | $44 - $326 | 95% |
| Pgm - Embassy Of The United Emirates/Ipc | $46 - $340 | 100% |
| Medicare (plans) | $48 - $49 | 104% |
| Philadelphia Va Medical Center | $48 | 104% |
| Tricare | $48 | 104% |
| Us Family Health Plan | $48 | 104% |
| Geisinger Health Plan | $49 - $152 | 106% |
| Humana | $49 - $389 | 106% |
| Ibc | $49 | 106% |
| Devoted Health | $50 | 108% |
| Pa Health And Wellness | $50 - $79 | 108% |
| Penn Life (Living Independently For Elders) | $50 | 108% |
| Clover Health Plan | $52 | 113% |
| Health America/Ccn | $52 - $389 | 113% |
| Intergroup | $52 - $389 | 113% |
| Pgm - Kuwait Health Division | $52 - $389 | 113% |
| Pgm - Kuwait Oil | $52 - $389 | 113% |
| Preferred Care | $52 - $389 | 113% |
| Keystone First | $53 | 115% |
| Gateway Health Plan | $59 | 128% |
| Blue Quality Centers For Transplant (Bqct) | $65 - $486 | 141% |
| City Of Philadelphia Behavioral Health | $65 - $486 | 141% |
| Commercial Other | $65 - $486 | 141% |
| Ibc Commercial Hpn | $65 - $82 | 141% |
| International Pfs | $65 - $486 | 141% |
| Keystone Hmo Proactive | $65 - $84 | 141% |
| Pa Medical Assistance | $65 - $486 | 141% |
| United Behavioral Health | $65 - $486 | 141% |
| Workers Compensation | $65 - $486 | 141% |
| Elap | $68 | 148% |
| Claims Watcher | $77 - $86 | 167% |
| Oscar Health Plan | $82 | 178% |
| Centivo | $86 | 187% |
| Elap Services | $89 | 193% |
| Highmark | $101 | 219% |
| Penn Global Medicine | $127 | 276% |