CMS Price Transparency Data

Orthotic fitting and training

Facility: Tristar Southern Hills Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $45
  • Cash Discount Price: $295
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at Tristar Southern Hills Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $295. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.98x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.
Cash / Self-Pay
$295

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $295 (640%)
Insurance Median: $45 (98%)
Cash: $295 (640% of Medicare)
Ins. Median: $45 (98% 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 $27 - $31 59%
Aetna $38 - $148 82%
Amerigroup $38 - $43 82%
Devoted Health Plan $38 - $43 82%
Healthspring $38 - $43 82%
Humana $38 - $74 82%
Odyssey Healthcare $38 - $43 82%
Sarah Cannon Research $38 - $43 82%
United $38 - $133 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 - $71 95%
Kentucky Labor Cabinet $54 117%
Oscar $54 117%
Prime Health $55 - $260 119%
Apex Health $56 122%
Corvel Corporation $56 - $64 122%
Nhc Advantage, Inc. $56 122%
Novanet $56 - $64 122%
Pruitt Health (Allyalign) $56 122%
Ambetter / Centene $66 - $69 143%
Cigna $74 - $96 161%
Bgfh Singlesource $148 - $251 321%
Multiplan $171 371%
Employers Health Network $207 449%
Odom'S Tn Pride Sausage $222 482%
Beech Street $260 564%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 391 Wallace Rd, Nashville, TN 37211
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals