CMS Price Transparency Data

Orthotic fitting and training

Facility: Southwestern Vermont Medical Center

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $45
Cash Discount Price: $89
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Southwestern Vermont Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 0.98x the Medicare baseline. Located in 100 Hospital Drive, Bennington, VT.

Cash / Self-Pay

$89

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: $89 (193%)

Insurance Median: $45 (98%)

Cash: $89 (193% 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.

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
Cdphp	$28 - $65	61%
Blue Cross Blue Shield	$36 - $45	78%
Mvp	$36 - $69	78%
UnitedHealthcare	$36 - $63	78%
Bmc	$39	85%
Hne	$39 - $45	85%
Tufts	$44	95%
Aetna	$45 - $51	98%
Cigna	$45 - $52	98%
Fidelis	$45 - $47	98%
Humana	$45	98%
Wellcare	$45	98%
Harvard Pilgrim	$52	113%
Health New England	$53	115%
Allegiance	$63	137%

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 $89.
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 Southwestern Vermont 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.