CMS Price Transparency Data
Occupational therapy (therapeutic activities)
Facility: Whittier Hospital Medical Center
Billing Code: 97530 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97530
- Insurance Median: $63
- Cash Discount Price: $17
- vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Whittier Hospital Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.80x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$17
Average discount available for prompt cash payment at this facility.
Insurance Median
$63
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: $17 (48%)
Insurance Median: $63 (180%)
Cash: $17 (48% of Medicare)
Ins. Median: $63 (180% 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 |
|---|---|---|
| Blue Cross Blue Shield | $4 - $293 | 11% |
| Physician Healthways | $6 - $21 | 17% |
| Aids Healthcare Foundation | $9 - $39 | 26% |
| Allied Physicians | $9 - $59 | 26% |
| Kaiser Foundation | $9 - $147 | 26% |
| Synermed | $9 - $39 | 26% |
| Ahmc Medi-Cal Reciprocity Agreement | $11 | 31% |
| Alta Med Health Network | $11 - $39 | 31% |
| Altamed Health Services Corporation | $11 | 31% |
| Beverly Hospital | $11 - $43 | 31% |
| Brand New Day | $11 - $48 | 31% |
| Emanate Health | $11 - $48 | 31% |
| Health Net | $11 - $126 | 31% |
| Healthy Way La | $11 | 31% |
| Heritage Provider Network | $11 - $53 | 31% |
| La Care Healthy Families/Healthy Kids | $11 | 31% |
| Non Contracted Medi-Cal | $11 | 31% |
| Physicians Healthways Medical Corporation | $11 | 31% |
| Prospect Health Plan | $11 - $63 | 31% |
| Monarch Healthplan | $12 | 34% |
| Avanti | $13 - $47 | 37% |
| Care First Health Plan | $13 | 37% |
| County Of Los Angeles Dept Of Health Services | $13 | 37% |
| Hollywood Presbyterian Adv Med Mcal | $13 | 37% |
| Hollywood Presbyterian Medpoint Mcal | $13 | 37% |
| La Care Health Plan | $13 - $116 | 37% |
| Medi Caid/ Medi Cal | $13 | 37% |
| Caloptima | $16 - $39 | 46% |
| Ahmc Reciprocity | $19 - $63 | 54% |
| Ahmc Reciprocity Agreement Senior/Commercial | $19 - $63 | 54% |
| Wear And Wood | $19 - $84 | 54% |
| Molina Medical Center | $24 - $82 | 68% |
| Central Health Plan Of California | $25 - $84 | 71% |
| Veterans Administration | $27 | 77% |
| Applecare Medical Group | $30 | 86% |
| UnitedHealthcare | $30 - $267 | 86% |
| Blue Shield Of California | $31 - $433 | 88% |
| Fmc Los Angeles County | $32 - $158 | 91% |
| Interplan Health Group | $32 | 91% |
| Aetna | $33 - $153 | 94% |
| Athens Administrators Ahmc Work Comp | $33 | 94% |
| Misc 1 | $33 | 94% |
| Multiplan Wc | $33 | 94% |
| Prospect Medical | $34 - $116 | 97% |
| Care 1St Health Plan | $37 - $126 | 106% |
| New Horizon Medical Group Inc | $37 - $126 | 106% |
| Alignment Health Plan | $39 | 111% |
| Alta Los Angeles Hospitals Inc | $39 | 111% |
| Apa/Aco Inc | $39 | 111% |
| Caremore | $39 | 111% |
| Central Health Plan | $39 | 111% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $39 | 111% |
| Easy Choice Health Plan | $39 | 111% |
| Humana | $39 | 111% |
| La Care Covered Direct | $39 | 111% |
| Medicare (plans) | $39 - $41 | 111% |
| Pacific Alliance Medical Center | $39 | 111% |
| Pacificare Of California | $39 | 111% |
| Private Pay | $39 | 111% |
| Scan Health Plan | $39 | 111% |
| Self-Pay | $39 | 111% |
| Tricare | $39 | 111% |
| Cost Containment | $40 - $136 | 114% |
| Universal Care | $40 - $147 | 114% |
| Molina Healthcare Of California | $41 | 117% |
| Asi/Flex | $43 - $147 | 123% |
| San Miguel Health Plan | $43 | 123% |
| Us Comp Care | $43 - $147 | 123% |
| Value Healthplan Of California | $43 - $147 | 123% |
| Community Care Network | $46 - $158 | 131% |
| Coventry Health Care | $46 - $158 | 131% |
| Coventry Health Care National Network | $46 - $158 | 131% |
| Interplan Corporation | $46 - $158 | 131% |
| Managed Care Administrators | $46 - $158 | 131% |
| Prohealth | $46 - $158 | 131% |
| Chinatown Service Center Pace | $47 | 134% |
| Ahmc Health | $49 | 140% |
| Knox-Keene Act | $49 | 140% |
| Multiplan | $53 - $178 | 151% |
| Capnet | $60 | 171% |
| Pacific Independent Physician Association | $60 | 171% |
| Cigna | $62 - $210 | 177% |
| Commercial Non Contract | $62 - $210 | 177% |
| Medi-Cal Sub Acute | $62 - $210 | 177% |
| One Legacy | $62 - $210 | 177% |
| Edward Medical Group | $65 | 185% |
| Allied Physicians Ipa | $69 | 197% |
| Davita Healthcare Partners | $94 | 268% |
| Health Net Inc | $96 - $135 | 274% |
| Healthnet | $118 - $234 | 336% |
| Great-West Healthcare Of California | $2,500 | 7129% |