Occupational therapy (therapeutic activities)
Facility: Adventist Health Bakersfield
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $137
- Cash Discount Price: $41
- vs. Medicare Baseline: 3.91x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 391% of the Medicare baseline (a markup of 291%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kaiser Mcal Ip/Op Only | $16 | 46% |
| Medi-Cal | $16 | 46% |
| Bc Medi-Cal | $19 | 54% |
| Healthnet Mcal | $19 | 54% |
| Kern Health Systems Mcal | $21 | 60% |
| Blue Shield Mcr Adv | $37 | 106% |
| Fhcn Pace Mcr Adv - All Plans | $37 | 106% |
| Healthnet Mcr Adv | $37 | 106% |
| Kaiser Mcr Adv Ip/Op Only | $37 | 106% |
| UnitedHealthcare | $37 - $267 | 106% |
| Universal Health Plan Mcare-All Other Plans | $37 | 106% |
| Amrcn Indian Hlth Proj Mcr Adv - All Plans | $45 | 128% |
| Network Provdrs Llc Mcare -All Payers | $48 | 137% |
| Oscar - All Plans | $59 | 168% |
| Kaiser Comm Hmo Ip/Op Only-All Other Plans | $64 | 182% |
| Employee Health Plan - All Plans | $67 | 191% |
| Centivo - All Plans | $84 | 240% |
| Aetna | $120 | 342% |
| Western Growers/Pinnacle- All Plans | $132 | 376% |
| County Of Kern - All Plans | $136 | 388% |
| Gem Care- All Plans | $136 | 388% |
| Kern Legacy Hp Epo - All Other Plans | $136 | 388% |
| Kern Legacy Share Select | $136 | 388% |
| Cigna | $142 | 405% |
| First Health/Coventry- All Plans | $164 | 468% |
| Phcs- All Plans | $177 | 505% |
| Interplan- All Plans | $191 | 545% |
| Healthnet Hmo/Pos/Ppo/Epo - All Other Plans | $203 | 579% |
| Affiliated Health Funds-All Plans | $218 | 622% |
| Integrated Health Plan-All Plans | $218 | 622% |
| Three Rivers Provider Network- All Plans | $218 | 622% |
| Beech Street- All Plans | $232 | 662% |
| Galaxy Health Network- All Plans | $246 | 701% |
| Blue Shield Epn | $335 | 955% |
| Blue Shield Epo/Ppo | $373 | 1064% |
| Blue Shield Hmo/Pos - All Other Plans | $373 | 1064% |
| Blue Cross Blue Shield | $482 - $652 | 1374% |