CMS Price Transparency Data

Orthotic fitting and training

Facility: Prisma Health Tuomey Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $64
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Prisma Health Tuomey Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.39x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $114 (247%)
Insurance Median: $64 (139%)
Cash: $114 (247% of Medicare)
Ins. Median: $64 (139% 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 $27 - $125 59%
Bluechoice [810] $27 - $125 59%
Medicaid / KanCare $27 - $64 59%
UnitedHealthcare $27 - $395 59%
Prisma Health Seniorcare Pace - Midlands [5400] $41 89%
Prisma Health Seniorcare Pace-Upstate [5200] $41 89%
Cigna $44 - $188 95%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $44 95%
Humana $44 - $132 95%
Medicare (plans) $44 - $46 95%
Triwest Healthcare Alliance Vcp [902] $44 95%
Va Community Care Network-Vaccn [903] $44 95%
Aetna $46 - $139 100%
Healthy Conn Prime-First Choice Vip Care [5300] $46 100%
Healthy Conn Prime-Molina Healthcare [5330] $46 100%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $46 100%
Tricare $46 100%
Scdc-Sc Dept Of Corrections [7232] $47 102%
Workers Comp [600] $61 132%
Promise Health Plan Contracted [2401] $62 - $106 135%
Orangeburg Senior Helping Center Pace [5401] $70 152%
Ambetter / Centene $81 176%
Bob Jones Univ-Pai [821] $106 230%
Meritain Health Contracted [2200] $113 - $139 245%
Preferred Administrators Contracted [2839] $123 267%
Planned Administrators [820] $125 271%
Medcost [2940] $130 - $146 282%
Atlantic Packaging Contracted [4833] $132 286%
Aps Healthcare System [2981] $141 306%
Multiplan/Phcs Contracted [2950] $157 341%
Vsp Vision Care [2986] $158 343%
First Health Contracted [2952] $164 356%
Furman Int/Allen University Student [2951] $164 356%
Quiktrip-First Health [3067] $164 356%
Golden Rule Insurance Company [2991] $395 857%
Oxford Health Plans [2992] $395 857%
Zzumr-Salt Lake City Ut [3169] $395 857%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals