CMS Price Transparency Data
Occupational therapy (therapeutic activities)
Facility: Monterey Park Hospital
Billing Code: 97530 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97530
- Insurance Median: $112
- Cash Discount Price: $331
- vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Monterey Park Hospital is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $331. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 3.19x the Medicare baseline. Located in 900 S Atlantic Blvd, Monterey Park, CA.
Cash / Self-Pay
$331
Average discount available for prompt cash payment at this facility.
Insurance Median
$112
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: $331 (944%)
Insurance Median: $112 (319%)
Cash: $331 (944% of Medicare)
Ins. Median: $112 (319% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 319% of the Medicare baseline (a markup of 219%). 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.
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 |
|---|---|---|
| Accountable Ipa | $9 | 26% |
| Allied Physicians | $9 - $59 | 26% |
| Alta Med Health Services Corp | $9 - $140 | 26% |
| Altamed Health Network | $9 - $39 | 26% |
| Assess Ipa | $9 | 26% |
| Blue Cross Blue Shield | $9 - $281 | 26% |
| Care 1St Mcl/Gar Cap | $9 | 26% |
| Family Health Alliance Medical Group | $9 - $60 | 26% |
| Healthnet Inc | $9 | 26% |
| La Care | $9 - $39 | 26% |
| Medical Managed Care Program | $9 | 26% |
| Molina Healthcare | $9 | 26% |
| Preferred Ipa Of California | $9 | 26% |
| Access Ipa Ancillary | $11 - $41 | 31% |
| Ahmc Healthcare Inc | $11 - $169 | 31% |
| Altamed Health Services | $11 | 31% |
| Applecare Medical Group | $11 - $31 | 31% |
| Associated Hispanic Physicians Ancillary | $11 - $32 | 31% |
| Beverly Hospital | $11 - $43 | 31% |
| Brand New Day | $11 - $49 | 31% |
| Community Health Plan | $11 | 31% |
| Esperanza Medical Group Ipa | $11 - $60 | 31% |
| Health Net Medi Cal | $11 | 31% |
| Healthy Way La | $11 | 31% |
| La Care Health Plan | $11 - $309 | 31% |
| Other Non-Contracted Medi-Cal | $11 | 31% |
| Preferred Ipa | $11 - $49 | 31% |
| Alhambra Community Dialysis Unit Inc | $12 - $337 | 34% |
| Aids Health Foundation | $13 - $39 | 37% |
| Avanti | $13 - $47 | 37% |
| Emanate Health | $13 - $49 | 37% |
| Hollywood Presbyterian Adv Med Mcal | $13 | 37% |
| Hollywood Presbyterian Medpoint Mcal | $13 | 37% |
| Maxi Med Inc/Ipa | $13 - $39 | 37% |
| Medi Cal | $13 | 37% |
| Pacific Independent Physician Association | $13 - $60 | 37% |
| Bella Vista Medical Group Ancillary | $16 | 46% |
| Central Health Plan | $16 | 46% |
| Caloptima Direct | $19 | 54% |
| Altamed Health Services Corporation | $20 - $56 | 57% |
| Care 1St M Cal | $20 - $56 | 57% |
| Crown City Medical Group Inc | $20 - $56 | 57% |
| Physician Healthways | $20 - $56 | 57% |
| Universal Care M Cal/Advantage Health Network | $20 - $56 | 57% |
| Veterans Administration | $27 | 77% |
| Bella Vista Medical Group | $31 - $169 | 88% |
| Interplan | $32 - $422 | 91% |
| Preferred Health Network | $32 - $450 | 91% |
| Aetna | $33 - $409 | 94% |
| Asi Flex Ppo W/C | $33 | 94% |
| Athens Administrators | $33 | 94% |
| Indemnity W Comp Fee Schedule | $33 | 94% |
| Multiplan | $33 - $478 | 94% |
| Senior Citizens Choice | $35 | 100% |
| Alignment Health Plan | $39 | 111% |
| Apa/Aco Inc | $39 | 111% |
| Blue Shield Of California | $39 - $433 | 111% |
| Cms | $39 | 111% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $39 | 111% |
| Easy Choice Health Plan | $39 | 111% |
| First Health Senior | $39 | 111% |
| Foundation Health Plan | $39 | 111% |
| Health Net | $39 - $135 | 111% |
| Health Net Inc | $39 - $234 | 111% |
| Humana | $39 | 111% |
| La Care Covered Direct | $39 | 111% |
| Medicare (plans) | $39 - $41 | 111% |
| Scan Health Plan | $39 | 111% |
| Secure Horizons | $39 | 111% |
| Self-Pay | $39 | 111% |
| Ucla/Impact Cancer | $39 | 111% |
| UnitedHealthcare | $39 - $393 | 111% |
| Employee Health Systems Medical Group | $40 - $112 | 114% |
| Global Care Medical Group Ipa | $40 - $253 | 114% |
| Healthnet/Ehs Capitation | $40 - $112 | 114% |
| Molina Healthcare Medi-Connect | $41 | 117% |
| San Miguel Health Plan | $43 | 123% |
| Ahmc Health Epo | $49 | 140% |
| Knox-Keene Act | $49 | 140% |
| Molina Healthcare Of California | $49 | 140% |
| Hispanic Physicians Ipa Medical Corporation | $50 - $140 | 143% |
| Garfield Medical Center | $54 | 154% |
| Ahmc Reciprocity Agreement Senior/Commercial | $60 - $169 | 171% |
| Allied Physicians Ipa | $60 | 171% |
| Community Health Plan M Cal Joy Ipa | $60 - $169 | 171% |
| Tenet Reciprocity | $60 - $169 | 171% |
| Healthcare Partners Affiliates Medical Group | $71 - $201 | 202% |
| Molina Medical Centers | $78 - $219 | 222% |
| Central Health Plan Of California | $80 - $225 | 228% |
| Health Net Of California | $117 - $336 | 334% |
| Care 1St Health Plan | $120 - $337 | 342% |
| Greater Los Angeles Dialysis Inc | $120 - $337 | 342% |
| One Health Plan | $120 - $775 | 342% |
| Choice Care Network | $130 - $365 | 371% |
| Healthnet | $130 - $365 | 371% |
| Universal Care | $140 - $393 | 399% |
| Corvel Corporation | $160 - $925 | 456% |
| Bce Emergis Corp | $170 - $478 | 485% |
| Commercial Non Contract | $200 - $562 | 570% |
| Mri/Ct Greater El Monte Hospital | $200 - $562 | 570% |
| Mri/Mra/Alhambra Hospital | $200 - $562 | 570% |
| Mri/Mra/Eladh | $200 - $562 | 570% |
| One Legacy | $200 - $562 | 570% |
| Pacificare | $219 - $263 | 624% |
| Cigna | $525 | 1497% |