CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Baptist Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $47
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Baptist Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.34x the Medicare baseline. Located in 123 Baptist Way, Pensacola, FL.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $20 (57%)
Insurance Median: $47 (134%)
Cash: $20 (57% of Medicare)
Ins. Median: $47 (134% 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
Aetna $15 - $151 43%
Pensacola $20 57%
Cha Health Plan $23 66%
UnitedHealthcare $23 - $234 66%
Fl Community Care Ltc $24 68%
Humana $24 - $46 68%
Mh Sunshine Mcaid $24 68%
Staywell $24 68%
Sunshine Health $24 68%
Simply Healthcare Healthy Kids $26 74%
Uwf Athletes $27 - $86 77%
Hospice Regency $40 114%
Hospice Covenant $45 128%
Medicare (plans) $45 128%
Healthspring Of Fl Al $46 131%
Mh Wellcare $47 134%
Wellcare $47 134%
Cigna $63 - $133 180%
Hospice Emerald Coast $66 188%
Fl Blue $67 - $335 191%
Escambia $80 228%
Private Healthcare $86 245%
First Health $92 262%
Wc Corvel $95 - $126 271%
Choicecare $100 285%
Mh Choicecare $100 285%
Multiplan $118 336%
Bc Fl $244 696%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 123 Baptist Way, Pensacola, FL 32503
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals