CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: HCA Florida Highlands Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $36
  • Cash Discount Price: $276
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at HCA Florida Highlands Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $276. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.03x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$276

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $276 (787%)
Insurance Median: $36 (103%)
Cash: $276 (787% of Medicare)
Ins. Median: $36 (103% 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

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
Freedom Health $24 68%
Devoted Health $30 - $34 86%
Humana $30 - $110 86%
Ndms Definitive Care $30 - $34 86%
United $30 - $124 86%
Wellmed $30 - $34 86%
Aetna $31 - $83 88%
Blue Cross Blue Shield $31 - $35 88%
American Health Plan $32 - $36 91%
Cigna $32 - $97 91%
Florida Complete Care $32 - $37 91%
Prominence Healthfirst $32 - $36 91%
Sunshine State $32 - $38 91%
Centurion $33 - $38 94%
Amerihealth Caritas $36 - $41 103%
Avmed $36 - $138 103%
Longevity Health Plan $36 - $41 103%
Prime Health $42 120%
Molina $52 148%
Oscar $52 148%
Simply Healthcare $65 185%
Office Of Sheiff Highland Co $97 277%
United Ppo $121 345%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals