CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: HCA Florida Memorial Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $39
  • Cash Discount Price: $288
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at HCA Florida Memorial Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $288. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.11x the Medicare baseline. Located in 3625 University Blvd S, Jacksonville, FL.
Cash / Self-Pay
$288

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $288 (821%)
Insurance Median: $39 (111%)
Cash: $288 (821% of Medicare)
Ins. Median: $39 (111% 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
Optimum Healthcare $19 - $29 54%
Hospice Community $24 - $27 68%
Hospice Haven $27 - $31 77%
Avmed $28 - $97 80%
Simply Healthcare $29 - $53 83%
Aetna $30 - $104 86%
Careplus $30 - $34 86%
Devoted Health $30 - $34 86%
Humana $30 - $100 86%
Ndms Definitive Care $30 - $34 86%
United $30 - $155 86%
United Behavioral Health $30 - $34 86%
Veterans Evaluation Services $30 - $34 86%
Wellmed $30 - $35 86%
Blue Cross Blue Shield $31 - $35 88%
American Health Plan $32 - $36 91%
Cigna $32 - $98 91%
Florida Complete Care $32 - $37 91%
Sunshine State $32 - $36 91%
Wellcare $32 - $36 91%
Gold Kidney $33 - $37 94%
Longevity $36 - $41 103%
Oscar $37 - $55 106%
City Of Jacksonville $41 117%
Corvel Corporation $41 117%
Prime Health $42 120%
Positive Healthcare $51 - $76 145%
Sunshine State Health Plan $59 - $88 168%
Molina Healthcare $62 - $93 177%
Centurion $64 - $96 182%
Corizon $69 - $104 197%
Plotkin Health $116 - $172 331%
Multiplan $180 - $293 513%
Evernorth $185 - $276 528%
Evolutions Healthcare $185 - $293 528%
Ppo Next $196 - $293 559%
Novanet $208 - $310 593%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3625 University Blvd S, Jacksonville, FL 32216
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals