CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Baptist Memorial Hospital Jonesboro, Inc.

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $129
Cash Discount Price: $81
vs. Medicare Baseline: 3.68x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Baptist Memorial Hospital Jonesboro, Inc. is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 3.68x the Medicare baseline. Located in 4800 East Johnson Avenue, Jonesboro, AR.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $81 (231%)

Insurance Median: $129 (368%)

Cash: $81 (231% of Medicare)

Ins. Median: $129 (368% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 368% of the Medicare baseline (a markup of 268%). 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
Novasys	$17 - $70	48%
Summit Community Care	$17	48%
Access Health Services	$18 - $256	51%
Caresource	$18	51%
Home State Health Plan	$26 - $106	74%
Humana	$26 - $106	74%
Aetna	$32 - $128	91%
Cigna	$33 - $111	94%
Blue Cross Blue Shield	$38 - $256	108%
Ppo Holdings	$40 - $162	114%
Magnolia Regional Health Center	$42 - $170	120%
Multiplan	$45 - $298	128%
Littler	$52 - $213	148%
Ppo Plus	$52 - $341	148%
Primewell	$63 - $256	180%
First Choice Health Plan Of Ms	$74 - $298	211%
Municipal Health Benefit Fund	$74 - $298	211%
Mpcn	$79 - $320	225%
Healthlink	$84 - $341	240%
UnitedHealthcare	$130	371%

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 $81.
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 Baptist Memorial Hospital Jonesboro, Inc. 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.