CMS Price Transparency Data
Occupational therapy (therapeutic activities)
Facility: Adventist Health White Memorial
Billing Code: 97530 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97530
- Insurance Median: $47
- Cash Discount Price: $72
- vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Adventist Health White Memorial is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.34x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$72
Average discount available for prompt cash payment at this facility.
Insurance Median
$47
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: $72 (205%)
Insurance Median: $47 (134%)
Cash: $72 (205% of Medicare)
Ins. Median: $47 (134% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Access Medi-Cal | $16 | 46% |
| Ahp Medi-Cal | $16 | 46% |
| Alta Los Angeles Mcal 1/1/19 | $16 | 46% |
| Avanti Mcal | $16 | 46% |
| Healthcare Inc Medi-Cal | $16 | 46% |
| Lasalle Mg Medi-Cal | $16 | 46% |
| Medi-Cal | $16 | 46% |
| Molina Medi-Cal | $16 | 46% |
| Pacific Alliance Medi-Cal | $16 | 46% |
| Pacific Ipa Medi-Cal | $16 | 46% |
| Preferred Ipa La Care Mcal Cap | $16 | 46% |
| Preferred Medi-Cal | $16 | 46% |
| Altamed Medi-Cal - All Other Plans | $18 | 51% |
| Fcs Ipa Medi-Cal Op/Profee Only | $19 | 54% |
| Healthnet Mcal | $19 | 54% |
| Preferred Healthy | $20 | 57% |
| Bc Medi-Cal | $21 | 60% |
| Assoc Hispanic Physcns Mcal | $22 | 63% |
| Access Group | $33 | 94% |
| Ahp - All Other Plans | $33 | 94% |
| Lasalle Mg Commercial - All Other Plans | $33 | 94% |
| Access Senior - All Other Plans | $39 | 111% |
| Ahp Senior | $39 | 111% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $39 | 111% |
| Altamed Connect | $39 | 111% |
| Avanti Mcr Adv - All Other Plans | $39 | 111% |
| Brand New Day Mcare - All Plans | $39 | 111% |
| Bs Va Mcare | $39 | 111% |
| Care First Mcare - All Other Plans | $39 | 111% |
| Clever Care - All Plans | $39 | 111% |
| Fcs Ipa Mcr Advan Op/Profee Only | $39 | 111% |
| Humana | $39 | 111% |
| Lasalle Mg Senior | $39 | 111% |
| Medicare (plans) | $39 | 111% |
| Molina Mcare | $39 | 111% |
| Pacific Alliance Mcare - All Other Plans | $39 | 111% |
| Preferred Senior | $39 | 111% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $39 | 111% |
| Tricare | $39 | 111% |
| UnitedHealthcare | $39 - $192 | 111% |
| Blue Shield Medi-Cal | $40 | 114% |
| Blue Cross Blue Shield | $41 - $549 | 117% |
| Fcs Ipa Op/Profee Only - All Other Plans | $41 | 117% |
| Bright Health - All Plans | $45 | 128% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $47 | 134% |
| Preferred Commercial - All Other Plans | $47 | 134% |
| Intergrated Medical - All Plans | $51 | 145% |
| Molina Benefit Exchange - All Other Plans | $53 | 151% |
| Care First Medi-Cal | $56 | 160% |
| Php-Prospect Health Plan Cap - All Plans | $59 | 168% |
| Ah Employee Health Plan - All Plans | $71 | 202% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $80 | 228% |
| Bella Vista Medi-Cal Op/Profee Only | $80 | 228% |
| Centivo - All Plans | $88 | 251% |
| Blue Shield Mcr Adv | $105 | 299% |
| Aetna | $114 | 325% |
| Pacific Ipa - All Other Plans | $152 | 433% |
| Caremore Mcare - All Plans | $154 | 439% |
| Kaiser- All Plans | $164 | 468% |
| Cigna | $170 | 485% |
| Healthnet - All Other Plans | $181 | 516% |
| Healthnet Comm Care | $187 | 533% |
| Hcpamg - All Plans | $201 | 573% |
| Healthcare Inc - All Other Plans | $221 | 630% |
| La Care Mcr Adv - All Plans | $221 | 630% |
| First Heatlh Ppo - All Plans | $233 | 664% |
| Phcs Ppo - All Plans | $261 | 744% |
| Scan Health Mcare - All Plans | $261 | 744% |
| Ahf - All Plans | $301 | 858% |
| Beech Street - All Plans | $301 | 858% |
| Interplan Ppo - All Plans | $301 | 858% |
| Corvel Corp - All Plans | $321 | 915% |
| Multiplan Ppo - All Plans | $333 | 950% |
| Healthmannet - All Plans | $341 | 972% |
| Next Inc Ppo - All Plans | $341 | 972% |
| Trpn - All Plans | $341 | 972% |
| Western Growers/Pinnacle - All Plans | $341 | 972% |
| Fpn Ppo - All Plans | $361 | 1029% |
| Blue Shield Epn | $460 | 1312% |
| Blue Shield - All Other Plans | $530 | 1511% |
| Healthnet Mcr Adv | $614 | 1751% |