CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: UF Health Shands Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $50
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 1.43x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at UF Health Shands Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.43x the Medicare baseline. Located in 1600 Sw Archer Rd, Gainesville, FL.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $95 (271%)
Insurance Median: $50 (143%)
Cash: $95 (271% of Medicare)
Ins. Median: $50 (143% 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
Beacon Health Strategies $24 68%
Humana $24 - $46 68%
Sunshine State Health Plan $24 68%
UnitedHealthcare $24 - $172 68%
Aetna $25 - $142 71%
Florida Community Care $25 71%
Amerihealth Caritas Florida $26 74%
Community Care Plan $26 74%
Molina $26 74%
Simply Healthcare $29 83%
Blue Cross Blue Shield $45 - $97 128%
Capital Health Plan $45 - $86 128%
North Central Hospice $45 128%
Wellcare $45 128%
Carelon Health $48 137%
Ahf Mco Of Fl $50 143%
Devoted Health Plan $50 143%
Freedom Health- Inc./Optimum Healthcare- Inc. $50 143%
Uaa $66 188%
Ambetter / Centene $69 197%
Northeast Fl Hospital $76 217%
Careplus $77 220%
Positive Healthcare Partners $77 220%
Florida Health Care Plan $86 245%
Wellpath $86 245%
Health First $120 342%
Prime Health Services $120 342%
Cigna $122 348%
Archbold Medical Center $129 368%
Genex $129 368%
Corvel Corp $146 416%
Geha $155 442%
Avmed $173 - $189 493%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Sw Archer Rd, Gainesville, FL 32610
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals