CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Canyon Vista Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $35
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Canyon Vista Medical Center is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.00x the Medicare baseline. Located in 5700 East Highway 90, Sierra Vista, AZ.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $87 (248%)
Insurance Median: $35 (100%)
Cash: $87 (248% of Medicare)
Ins. Median: $35 (100% 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.

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
University Phyicians Inc $27 77%
Wellcare By Allwell $27 77%
Aetna $28 - $115 80%
Azch-Complete Care Plan $28 80%
Medicare (plans) $28 80%
Blue Cross Blue Shield $30 - $127 86%
Humana $31 88%
UnitedHealthcare $32 - $94 91%
Arizona Physicians Ipa Inc $33 94%
Veteran Family Member Program $37 106%
Ambetter / Centene $43 123%
Government Employees Health Association $94 268%
Samba $129 368%
Meritain Health $268 764%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5700 East Highway 90, Sierra Vista, AZ 85635
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals