Occupational therapy (therapeutic activities)
Facility: Modoc Medical Center
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $58
- Cash Discount Price: $66
- vs. Medicare Baseline: 1.65x 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.
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 |
|---|---|---|
| Adv Med Mgmt - All Plans | $16 | 46% |
| Medi-Cal | $16 | 46% |
| Medi-Cal 7/1/24 | $16 | 46% |
| Multiplan Wc | $35 | 100% |
| Blue Shield Mcr Adv | $36 | 103% |
| Blue Shield Va | $36 | 103% |
| UnitedHealthcare | $36 - $63 | 103% |
| Integrated Hp Wc | $37 | 106% |
| Ntwrks By Design Wc - All Plans | $37 | 106% |
| Healthnet Mcr Adv | $38 | 108% |
| Tricare | $38 | 108% |
| Blue Cross Blue Shield | $54 - $60 | 154% |
| Blue Shield Exch | $54 | 154% |
| Partnership Hp - All Plans | $56 | 160% |
| Blue Shield Comm - All Other Plans | $60 | 171% |
| Carelon - All Plans | $60 | 171% |
| Corvel - All Plans | $62 | 177% |
| Aetna | $63 | 180% |
| Coventry/First Health - All Plans | $63 | 180% |
| Galaxy Health - All Plans | $63 | 180% |
| Healthnet Comm - All Other Plans | $63 | 180% |
| Hmn - All Plans | $63 | 180% |
| Integrated Hp - All Other Plans | $63 | 180% |
| Interplan - All Plans | $63 | 180% |
| Multiplan - All Other Plans | $63 | 180% |
| Superior Ca Ppo - All Plans | $63 | 180% |