CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 97530 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$39

about 1.1× the $35 Medicare rate · typically $29–$73

modeled estimate · not a bill or quote

Medicare pays $35 Fair price $39 Cash price $172 Hospital's list price $229

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$146	416%
Blue Cross Blue Shieldmajor	$128 - $183	365%
Aetnamajor	$89 - $172	254%
Cignamajor	$34 - $224	97%
Humanamajor	$160 - $224	456%
Kaiser Permanentemajor	$68 - $150	194%
Health Net	$68 - $206	194%
Molina	$68 - $172	194%
+ 6 smaller / regional plans	$68 - $183

Government programs also on file: Medicare, Medicaid.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 172), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 97530.

Insurance Before you use insurance

Call your insurance company to confirm Sharp Coronado Hospital and Hlthcr Ctr is in-network.
Ask your insurer whether prior approval is required for CPT code 97530.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sharp Coronado Hospital and Hlthcr Ctr

Compare: Occupational therapy (therapeutic activities) at other CA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.