CMS Price Transparency Data

Orthotic fitting and training

Facility: Cedar City Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $108
Cash Discount Price: $90
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Cedar City Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 2.34x the Medicare baseline. Located in 1303 North Main Street, Cedar City, UT.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$108

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: $90 (195%)

Insurance Median: $108 (234%)

Cash: $90 (195% of Medicare)

Ins. Median: $108 (234% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 234% of the Medicare baseline (a markup of 134%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Choice	$37 - $106	80%
Health Plan Of Nevada	$37 - $106	80%
Healthy U	$37 - $106	80%
Molina	$37 - $114	80%
Selecthealth	$37 - $108	80%
Aetna	$44 - $115	95%
Health Partners Of Nevada	$44 - $47	95%
UnitedHealthcare	$44 - $108	95%
American Health	$46 - $47	100%
Southwest Behavioral Health	$46 - $47	100%
Triwest	$46	100%
Blue Cross Blue Shield	$47 - $114	102%
Humana	$47	102%
Corporation Of The President	$90	195%
Corvel Corporation	$90	195%
Injury Care Of Nevada	$90	195%
Wcf Insurance	$90	195%
Byu Risk Management	$102	221%
Awh Connected	$108 - $109	234%
Byu Athletic Department	$108	234%
Campbell Scientific	$108	234%
Deseret Mutual	$108	234%
Emi	$108	234%
Emi Health	$108	234%
Franklin County	$108	234%
Global Excel	$108	234%
Ifit	$108	234%
Juniper Systems	$108	234%
Lw Miller	$108	234%
Managed Care Admin	$108	234%
Medcare International	$108	234%
Motivhealth	$108	234%
Pehp	$108 - $114	234%
Prodegi Corp Benefit	$108	234%
Tanner Llc	$108	234%
Uofu	$108 - $114	234%
Utah Tech	$108	234%
Wise Network	$108	234%
Cigna	$114	247%
Health Utah	$114	247%
Hygeia Corporation	$114	247%
Springtide	$114	247%

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 $90.
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 Cedar City 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.