CMS Price Transparency Data

Orthotic fitting and training

Facility: Blount Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $75
Cash Discount Price: $39
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Blount Memorial Hospital is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.63x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$75

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: $39 (85%)

Insurance Median: $75 (163%)

Cash: $39 (85% of Medicare)

Ins. Median: $75 (163% 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.

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
Medicaid / KanCare	$19 - $39	41%
UnitedHealthcare	$19 - $190	41%
Prisma Health Seniorcare Pace - Midlands [5400]	$29	63%
Prisma Health Seniorcare Pace-Upstate [5200]	$29	63%
Blue Cross Blue Shield	$43 - $153	93%
Humana	$43	93%
Medicare (plans)	$43 - $45	93%
Promise Health Plan Contracted [2401]	$44 - $75	95%
Cigna	$45 - $186	98%
Tricare	$46	100%
Orangeburg Senior Helping Center Pace [5401]	$50	108%
Ambetter / Centene	$67	145%
Bob Jones Univ-Pai [821]	$75	163%
Preferred Administrators Contracted [2839]	$88	191%
Medcost [2940]	$92 - $104	200%
Atlantic Packaging Contracted [4833]	$94	204%
Consociate Health Contracted [4835]	$95	206%
Aps Healthcare System [2981]	$100	217%
Multiplan/Phcs Contracted [2950]	$111	241%
Aetna	$112	243%
Meritain Health Contracted [2200]	$112	243%
Nippon [2300]	$112	243%
Vsp Vision Care [2986]	$112	243%
First Health Contracted [2952]	$116	252%
Furman Int/Allen University Student [2951]	$116	252%
Quiktrip-First Health [3067]	$116	252%
Fairos/Occunet Contracted [4837]	$175	380%
Mvp Health Care [3037]	$186	404%
Golden Rule Insurance Company [2991]	$190	412%
Oxford Health Plans [2992]	$190	412%

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 $39.
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 Blount Memorial Hospital 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.