CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: HCA Florida Kendall Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $42
  • Cash Discount Price: $1,299
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at HCA Florida Kendall Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,299. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.20x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.
Cash / Self-Pay
$1,299

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $1,299 (3704%)
Insurance Median: $42 (120%)
Cash: $1,299 (3704% of Medicare)
Ins. Median: $42 (120% 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
Careplus Sfl $32 - $36 91%
Cigna $32 - $273 91%
Devoted Health $32 - $36 91%
Humana $32 - $442 91%
Leon Health $32 - $36 91%
Ndms Definitive Care $32 - $36 91%
United $32 - $585 91%
United Behavioral Health $32 - $36 91%
Veterans Evaluation Services $32 - $36 91%
Wellmed $32 - $36 91%
Aetna $33 - $390 94%
Blue Cross Blue Shield $33 - $37 94%
Align $34 - $39 97%
American Health Plan $34 - $39 97%
Florida Complete Care $34 - $39 97%
Oscar $34 - $208 97%
Prominence Healthfirst $34 - $38 97%
Sunshine State $34 - $40 97%
Avmed $35 - $650 100%
Centurion $35 - $40 100%
Doctors Healthcare Plan $35 - $40 100%
Gold Kidney $36 - $41 103%
Amerihealth Caritas $38 - $221 108%
Longevity Health Plan $38 - $44 108%
Corvel Corporation $44 125%
Careworks (Rockport) $45 128%
Prime Health $45 128%
Solis Health Plan $46 - $53 131%
Naphcare $54 - $62 154%
Seven Corners $67 - $87 191%
Wellpath $67 - $87 191%
Freedom Health $112 - $208 319%
Optimum $112 319%
Simply Healthcare Plans $169 482%
Simply Healthcare $175 499%
Molina $247 - $351 704%
Health Sun Health Plan $277 790%
Aids Healthcare $286 - $1,559 816%
Mmm Of Fl (Health Advantage Plan) $299 853%
United Ppo $308 878%
Sunshine State Health Plan $338 964%
Plotkin Health $650 1853%
Prime Health Sherriff $650 1853%
Medica Healthcare $753 2147%
Multiplan $974 - $1,104 2777%
Evernorth Bh $1,039 2963%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11750 Bird Rd, Miami, FL 33175
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals