CMS Price Transparency Data

Orthotic fitting and training

Facility: Tristar Horizon Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $43
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Tristar Horizon Medical Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.93x the Medicare baseline. Located in 111 Highway 70 East, Dickson, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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%)
Insurance Median: $43 (93%)
Ins. Median: $43 (93% 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
Wellpoint $34 - $39 74%
Aetna $38 - $44 82%
Amerigroup $38 - $43 82%
Devoted Health Plan $38 - $43 82%
Healthspring $38 - $43 82%
Humana $38 - $43 82%
Sarah Cannon Research $38 - $43 82%
United $38 - $44 82%
Blue Cross Blue Shield $39 - $93 85%
Wellcare $39 - $45 85%
Zing $39 - $45 85%
American Health Advantage $40 - $45 87%
Evergreen Hmo $40 - $45 87%
Signature Advantage $40 - $46 87%
Atrio Golden Times $42 - $48 91%
Bright Health $44 - $50 95%
Prime Health $55 - $62 119%
Corvel Corporation $56 - $64 122%
Novanet $56 - $64 122%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Highway 70 East, Dickson, TN 37055
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals