CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Banner Fort Collins Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $113
Cash Discount Price: $15
vs. Medicare Baseline: 3.22x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Banner Fort Collins Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 3.22x the Medicare baseline. Located in 4700 Lady Moon Dr, Fort Collins, CO.

Cash / Self-Pay

$15

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $15 (43%)

Insurance Median: $113 (322%)

Cash: $15 (43% of Medicare)

Ins. Median: $113 (322% 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 322% of the Medicare baseline (a markup of 222%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Banner Health	$53	151%
Assist Health Group	$64	182%
Centivo	$64	182%
Hue Health, Inc	$90	257%
Medica	$107	305%
Rocky Mountain Health Plans	$109	311%
Apostrophe, Inc.	$110	314%
Decent Health	$110	314%
First Choice Health Network	$116	331%
Multiplan	$121	345%
First Choice Of The Midwest	$123	351%
UnitedHealthcare	$251 - $398	716%
Blue Cross Blue Shield	$291	830%
Aetna	$298	850%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $15.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97530.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner Fort Collins Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97530.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.