CMS Price Transparency Data

Orthotic fitting and training

Facility: St Mary Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $79
  • Cash Discount Price: $140
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at St Mary Medical Center is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.71x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$140

Average discount available for prompt cash payment at this facility.

Insurance Median
$79

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: $140 (304%)
Insurance Median: $79 (171%)
Cash: $140 (304% of Medicare)
Ins. Median: $79 (171% 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
Pace-Trinity Health $28 61%
Medicaid / KanCare $38 - $79 82%
Blue Cross Blue Shield $43 - $49 93%
UnitedHealthcare $47 - $114 102%
Cigna $48 - $358 104%
Align Senior Care $49 106%
Amerihealth $49 106%
Blue Shield - Ca $49 106%
Blue Shield - Id (Regence) $49 106%
Blue Shield - Ny Highmark Western $49 106%
Blue Shield - Wa (Regence) $49 106%
Medicare (plans) $49 - $86 106%
Aetna $51 - $191 111%
Health America Advantra $57 124%
Keystone First $79 171%
Keystone First Chip $79 171%
Ambetter / Centene $85 184%
Oscar $86 187%
Prime Healthcare $86 187%
Jefferson Health Plan Commercial $87 189%
Homestead Health Plans Woods Center $93 202%
Group Pension Administrators $108 234%
Reedman Toll $108 234%
Geha $114 247%
Blue Shield - Pa (Highmark) $129 280%
Meritain $191 414%
Multiplan $194 421%
Prime Health Services $194 421%
Galaxy Health Network $204 443%
Three Rivers Provider Network $204 443%
Upmc Health Plan $358 777%
Webtpa $358 777%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals