CMS Price Transparency Data

Orthotic fitting and training

Facility: Erlanger Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $64
Cash Discount Price: $92
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Erlanger Medical Center is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.39x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$92

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: $92 (200%)

Insurance Median: $64 (139%)

Cash: $92 (200% 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.

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
Bluecare	$24 - $145	52%
Blue Cross Blue Shield	$28 - $140	61%
UnitedHealthcare	$32 - $114	69%
Cigna	$36 - $200	78%
Amerigroup	$37 - $133	80%
Caresource	$37 - $120	80%
Humana	$38 - $67	82%
Aetna	$40 - $86	87%
Alexian	$60 - $64	130%
Clover	$60 - $64	130%
Upmc	$60 - $64	130%
American Health	$62 - $66	135%
Devoted Health	$63 - $66	137%
Nhc	$63 - $67	137%
Medicare (plans)	$64	139%
Pruitthealth Premier	$65	141%
Atrio Health	$66 - $70	143%
Simpra Advantage	$70	152%
Wellpoint	$70	152%
Ambetter / Centene	$75 - $80	163%
Pnoa	$81 - $151	176%
Caresource Ga	$89 - $160	193%
Caresource Tn	$89 - $160	193%
Olympus	$96 - $131	208%
Alliant	$102 - $131	221%
Caresource Nc	$107 - $160	232%
Occunet	$111	241%
Point Comfort Underwriters	$112 - $115	243%
First Health	$140 - $149	304%

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 $92.
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 Erlanger Medical Center 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.