CMS Price Transparency Data

Orthotic fitting and training

Facility: UPMC Muncy

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $143
Cash Discount Price: $130
vs. Medicare Baseline: 3.10x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at UPMC Muncy is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.10x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $130 (282%)

Insurance Median: $143 (310%)

Cash: $130 (282% of Medicare)

Ins. Median: $143 (310% 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 310% of the Medicare baseline (a markup of 210%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Highmark Wholecare (Prev Gateway)	$33	72%
Upmc Health Plan	$33 - $95	72%
Amerihealth Caritas	$34 - $2,208	74%
Cigna	$34 - $149	74%
Pa Health & Wellness	$35 - $2,316	76%
UnitedHealthcare	$35 - $148	76%
Upmc Work Partners	$43	93%
Three Rivers Provider Network	$53 - $195	115%
Blue Cross Blue Shield	$85 - $100	184%
Aetna	$88 - $143	191%
Coventry/First Health	$109 - $146	236%
Wirerope Works	$121	263%
Geisinger	$145	315%
Multiplan	$169 - $206	367%
America'S Choice	$174	378%
Intergroup	$174	378%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $130.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97760.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Muncy is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97760.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.