CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Larkin Community Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $66
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Larkin Community Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.88x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $119 (339%)
Insurance Median: $66 (188%)
Cash: $119 (339% of Medicare)
Ins. Median: $66 (188% 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
Medicaid / KanCare $15 - $23 43%
Corvel Mcaid Workers Comp $20 57%
Sunshine Behavioral $20 57%
Aetna $22 - $173 63%
Ambetter / Centene $22 63%
Community Care Phks Mcaid-All Other Plans $22 63%
Florida Comm Care Mcaid $22 63%
Humana $22 - $173 63%
Magellan Complete Care $22 63%
Molina Exch Marketplace-All Other Plans $22 63%
UnitedHealthcare $22 - $100 63%
Blue Cross Blue Shield $34 - $258 97%
Florida Comm Care Mcare-All Other Plans $36 103%
Medicare (plans) $36 - $182 103%
Ops Maritime-All Plans $36 103%
Opus Hospice Ip Only-All Plans $36 103%
Preferred Care Partners Mcare-All Plans $36 103%
Clear Springs Hlth-All Plans $37 106%
Unicare Simply Mcare Ppo-All Plans $37 106%
Wellpath-All Plans $39 111%
Fci-All Plans $41 117%
Cigna $42 - $43 120%
Allianz (Azga)-All Plans $46 131%
Healthsun-All Plans $50 - $52 143%
United Prop Casualty-All Plans $65 185%
Star Network-All Plans $67 - $69 191%
Jmh Health Plan Hmo/Ppo-All Other Plans $75 214%
Global Excel-All Plans $101 - $104 288%
Haa Preferred Partners-All Plans $101 - $104 288%
Corvel Mcare Workers Comp-All Plans $151 - $156 431%
Avmed-All Plans $168 - $173 479%
Careplus Health-All Other Plans $168 - $173 479%
Centurion-All Plans $168 - $173 479%
Coventry Comml-All Plans $168 - $173 479%
Doctors Healthcare-All Plans $168 - $173 479%
First Med Hp Of Fl-All Plans $168 - $173 479%
Florida Health Solution/Hmo-All Plans $168 - $173 479%
Bright Health-All Other Plans $202 - $208 576%
Oscar Health-All Plans $336 - $346 958%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7031 Sw 62Nd Ave, South Miami, FL 33143
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals