CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Ochsner Choctaw General

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $63
Cash Discount Price: $117
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Ochsner Choctaw General is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.80x the Medicare baseline. Located in 401 Vanity Fair Lane, Po Box 618, Butler, AL.

Cash / Self-Pay

$117

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$35.07

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $35.07 (100%)

Cash / Self-Pay: $117 (334%)

Insurance Median: $63 (180%)

Cash: $117 (334% of Medicare)

Ins. Median: $63 (180% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $35.07 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
Blue Cross Blue Shield	$27 - $119	77%
Humana	$27 - $69	77%
Medicaid / KanCare	$30 - $32	86%
Cigna	$32 - $75	91%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$32 - $69	91%
Medicare (plans)	$32 - $80	91%
UnitedHealthcare	$32 - $110	91%
Select Administrative Services Network	$33 - $108	94%
Shared Health Mississippi	$33 - $73	94%
Claritev D/B/A Multiplan/Phcs/American Life Care	$37 - $116	106%
Prime Health Services Ppo	$37 - $123	106%
Aetna	$46 - $100	131%
Primewell Health Services Commercial Exchange Plan	$51 - $103	145%
Primewell Health Services – Commercial	$51 - $103	145%
Zelis	$62 - $116	177%
Prime Health Services Ppo -Workers Comp	$63 - $123	180%
Cor Vel	$64 - $126	182%
Ambetter / Centene	$70	200%

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 $117.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97530.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Choctaw General is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97530.
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.