CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Banner Payson Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $30
  • Cash Discount Price: $9
  • vs. Medicare Baseline: 0.86x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Banner Payson Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 0.86x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$9

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $9 (26%)
Insurance Median: $30 (86%)
Cash: $9 (26% of Medicare)
Ins. Median: $30 (86% 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
Arizona Physicians Ipa $16 - $27 46%
Health Net $16 - $41 46%
Mercy Care $16 - $27 46%
Aetna $27 - $81 77%
Banner Health $27 77%
Banner University Health Plan $27 77%
Blue Cross Blue Shield $27 - $172 77%
Care 1St $27 77%
Cigna $27 - $53 77%
Gila River Health Care Corporation $27 77%
Health Choice Arizona, Inc. $27 - $39 77%
Kaiser Foundation Health Plan $27 77%
Triwest Healthcare Alliance Corp - Va Ccn $27 77%
UnitedHealthcare $27 - $45 77%
Upmc Health Plan $27 77%
Wellpoint $27 77%
Carelon $29 83%
Humana $29 83%
Arizona Priority Care $30 86%
Devoted Health Services $30 86%
Gold Kidney Health Plan $30 86%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $30 86%
Plotkin Health $30 86%
Oscar Health Plan $45 128%
Quiktrip Corporation $47 134%
Arizona Medical Network $60 171%
Provider Network Of America $60 171%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 807 South Ponderosa Drive, Payson, AZ 85541
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals