CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: HCA Florida Jfk Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $38
  • Cash Discount Price: $385
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at HCA Florida Jfk Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.08x the Medicare baseline. Located in 5301 S Congress Ave, Atlantis, FL.
Cash / Self-Pay
$385

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $385 (1098%)
Insurance Median: $38 (108%)
Cash: $385 (1098% of Medicare)
Ins. Median: $38 (108% 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
Palm Beach Pace $30 - $34 86%
Careplus Sfl $31 - $36 88%
Devoted Health $31 - $36 88%
Humana $31 - $131 88%
Ndms Definitive Care $31 - $36 88%
United $31 - $173 88%
United Behavioral Health $31 - $36 88%
Veterans Evaluation Services $31 - $36 88%
Wellmed $31 - $36 88%
Aetna $32 - $116 91%
Blue Cross Blue Shield $32 - $36 91%
American Health Plan $33 - $38 94%
Freedom Health $33 - $62 94%
Optimum $33 94%
Oscar $33 - $62 94%
Prominence Healthfirst $33 - $37 94%
Sunshine State $33 - $39 94%
Align $34 - $38 97%
Centurion $34 - $39 97%
Cigna $34 - $81 97%
Doctors Healthcare Plan $34 - $39 97%
Florida Complete Care $34 - $38 97%
Gold Kidney $35 - $40 100%
Amerihealth Caritas $38 - $65 108%
Longevity Health Plan $38 - $43 108%
Corvel Corporation $43 123%
Careworks (Rockport) $44 125%
Prime Health $44 125%
Solis Health Plan $45 - $52 128%
Avmed $50 - $192 143%
Simply Healthcare Plans $50 143%
Simply Healthcare $52 148%
Molina $65 - $104 185%
Health Sun Health Plan $82 234%
Aids Healthcare $85 - $462 242%
Mmm Of Fl (Health Advantage Plan) $89 254%
United Ppo $91 259%
Sunshine State Health Plan $100 285%
Blis $135 385%
District Cares $192 547%
Plotkin Health $192 547%
Prime Health Sherriff $192 547%
Medica Healthcare $227 647%
Multiplan $289 - $327 824%
Evernorth Bh $308 878%
Healthy Palm Beaches $550 1568%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5301 S Congress Ave, Atlantis, FL 33462
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals