CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Marion Communtiy Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $42
  • Cash Discount Price: $431
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Marion Communtiy Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $431. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.20x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$431

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: $431 (1229%)
Insurance Median: $42 (120%)
Cash: $431 (1229% 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
Devoted Health $30 - $34 86%
Humana $30 - $112 86%
Ndms Definitive Care $30 - $34 86%
United $30 - $252 86%
Va Purchased Care Program $30 - $34 86%
Veterans Evaluation Services $30 - $34 86%
Wellmed $30 - $34 86%
Blue Cross Blue Shield $31 - $35 88%
Freedom Optimum $31 - $35 88%
Align Senior Care $32 - $37 91%
American Health Plan $32 - $36 91%
Avmed $32 - $157 91%
Cigna $32 - $233 91%
Florida Complete Care $32 - $37 91%
Sunshine State $32 - $36 91%
Wellcare $32 - $36 91%
Aetna $33 - $168 94%
Centurion $33 - $38 94%
Clear Spring Health $33 - $38 94%
Gold Kidney Of Florida $33 - $37 94%
Secur $33 - $37 94%
Careplus $34 - $39 97%
Ultimate Health Plan $35 - $40 100%
Longevity Health Plan $36 - $41 103%
Simply Healthcare $38 - $71 108%
Corvel Corporation $41 117%
Prime Health $42 120%
Careworks (Rockport Community) $43 123%
Marion County Schools $43 123%
Molina Healthcare $57 - $180 163%
Naphcare $64 - $82 182%
University Ma Federal Corrections $64 - $72 182%
Wellpath $64 - $82 182%
Evolutions $69 - $129 197%
Evolutions Healthcare $69 - $129 197%
Sunshine State Health Plan $77 - $143 220%
Plotkin Health $150 - $281 428%
Prime Health Sheriff $150 - $281 428%
Multiplan $235 - $438 670%
Ppo Next $256 - $477 730%
Novanet $271 - $505 773%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals