CMS Price Transparency Data

Orthotic fitting and training

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $207
Cash Discount Price: $225
vs. Medicare Baseline: 4.49x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Childrens Hospital of the Kings Daughters Inc is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 4.49x the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$207

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: $225 (488%)

Insurance Median: $207 (449%)

Cash: $225 (488% of Medicare)

Ins. Median: $207 (449% 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 449% of the Medicare baseline (a markup of 349%). 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
Blue Cross Blue Shield	$53 - $114	115%
UnitedHealthcare	$53 - $226	115%
Amerihealth Caritas	$57 - $63	124%
Healthy Blue	$57 - $63	124%
Carolina Complete Health	$59 - $65	128%
Wellcare	$59 - $65	128%
Sentara Community Plan	$62	135%
Aetna	$65 - $226	141%
Humana	$65	141%
Sentara Health Plans	$116 - $127	252%
Cigna	$166 - $183	360%
Virginia Health Network	$175 - $220	380%
Medcost	$212 - $253	460%
First Health	$225 - $248	488%
Multiplan	$230 - $253	499%
Phcs	$230 - $261	499%
Vhn	$230 - $261	499%
Johns Hopkins Healthcare	$237 - $261	514%

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 $225.
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 Childrens Hospital of the Kings Daughters Inc 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.