CMS Price Transparency Data
Orthotic fitting and training
Facility: Pennsylvania Hospital
Billing Code: 97760 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97760
- Insurance Median: $65
- Cash Discount Price: $264
- vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Pennsylvania Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.41x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$264
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: $264 (573%)
Insurance Median: $65 (141%)
Cash: $264 (573% 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
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 |
|---|---|---|
| Horizon Nj Health | $11 - $81 | 24% |
| Medicaid / KanCare | $12 - $462 | 26% |
| Keystone Mercy Health Plan | $13 - $92 | 28% |
| Pgm - Regie De L'Assurance Maladie Quebec | $15 - $106 | 33% |
| Upmc | $16 - $462 | 35% |
| Preferred Health Care Eliance | $17 - $120 | 37% |
| Blue Cross Blue Shield | $18 - $462 | 39% |
| Cigna | $22 - $156 | 48% |
| Pgm - Kuwait Defense | $23 - $208 | 50% |
| Devon | $25 - $208 | 54% |
| Qualcare | $25 - $176 | 54% |
| Coventry | $26 - $236 | 56% |
| Pgm - Chop | $26 - $185 | 56% |
| Wissahickon Hospice | $26 - $185 | 56% |
| Aetna | $27 - $462 | 59% |
| Healthamerica/Coventry | $29 - $226 | 63% |
| First Health Global | $32 - $231 | 69% |
| Health Partners | $32 - $462 | 69% |
| Olympus | $32 - $225 | 69% |
| Urn-Cancer Resource Services | $32 - $231 | 69% |
| Health Net | $39 - $277 | 85% |
| Pgm - Royal Embassy Of Saudi Arabia | $39 - $277 | 85% |
| Pgm - Embassy Of Qatar | $42 - $300 | 91% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $42 - $300 | 91% |
| Pgm - Embassy Of The United Emirates/Ipc | $46 - $323 | 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 - $151 | 106% |
| Humana | $49 - $370 | 106% |
| Ibc | $49 | 106% |
| Pa Health And Wellness | $50 - $79 | 108% |
| Penn Life (Living Independently For Elders) | $50 | 108% |
| Clover Health Plan | $51 | 111% |
| UnitedHealthcare | $51 - $462 | 111% |
| Devon Health Services Inc | $52 - $370 | 113% |
| Health America/Ccn | $52 - $370 | 113% |
| Intergroup | $52 - $370 | 113% |
| Pgm - Kuwait Health Division | $52 - $370 | 113% |
| Pgm - Kuwait Oil | $52 - $370 | 113% |
| Preferred Care | $52 - $370 | 113% |
| Keystone First | $53 | 115% |
| Gateway Health Plan | $59 | 128% |
| Commercial Other | $65 - $462 | 141% |
| Community Behavioral Health | $65 - $462 | 141% |
| Ibc Commercial Hpn | $65 - $82 | 141% |
| International Pfs | $65 - $462 | 141% |
| Keystone Hmo Proactive | $65 - $84 | 141% |
| Quest Behavioral Health | $65 - $462 | 141% |
| United Behavioral Health | $65 - $462 | 141% |
| Workers Compensation | $65 - $462 | 141% |
| Elap | $68 | 148% |
| Claims Watcher | $76 - $86 | 165% |
| Oscar Health Plan | $81 | 176% |
| Centivo | $86 | 187% |
| Elap Services | $89 | 193% |
| Highmark | $100 | 217% |
| Penn Global Medicine | $126 | 273% |