CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: HCA Florida Lawnwood Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $39
  • Cash Discount Price: $423
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at HCA Florida Lawnwood Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $423. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.11x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
$423

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: $423 (1206%)
Insurance Median: $39 (111%)
Cash: $423 (1206% 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
Freedom Health $23 - $69 66%
Optimum $23 - $37 66%
Careplus $31 - $36 88%
Devoted Health $31 - $36 88%
Humana $31 - $172 88%
Ndms Definitive Care $31 - $36 88%
United $31 - $193 88%
United Behavioral Health $31 - $36 88%
Veterans Evaluation Services $31 - $36 88%
Wellmed $31 - $36 88%
Aetna $32 - $223 91%
Blue Cross Blue Shield $32 - $313 91%
Bright Health $32 - $127 91%
Cigna $32 - $271 91%
Mutual Of Omaha $32 - $36 91%
Rocky Mountain Health $32 - $36 91%
Total Longterm Care $32 - $36 91%
Triwest Health Alliance $32 - $36 91%
Ultimate Health Plan $32 - $36 91%
American Health Plan $33 - $38 94%
Innovage Pace $33 - $37 94%
Kaiser $33 - $150 94%
Prominence Healthfirst $33 - $37 94%
Sunshine State $33 - $39 94%
Wellcare $33 - $38 94%
Centurion $34 - $39 97%
Delaware Life Insurance $34 - $38 97%
Florida Complete Care $34 - $38 97%
Avmed $35 - $214 100%
Simply Healthcare Plans $35 - $56 100%
Amerihealth Caritas $38 - $43 108%
Longevity Health Plan $38 - $43 108%
Corvel Corporation $43 123%
Careworks (Rockport) $44 125%
Prime Health $44 - $381 125%
Solis Health Plan $45 - $52 128%
Molina $51 - $116 145%
Oscar $51 - $82 145%
Health Sun Health Plan $57 - $91 163%
Simply Healthcare $63 - $101 180%
Vail Health $64 182%
Sunshine State Health Plan $68 - $109 194%
Office Of Sheiff Highland Co $93 - $150 265%
United Ppo $117 - $189 334%
Plotkin Health $133 - $214 379%
Prime Health Sherriff $133 - $214 379%
Multiplan $200 - $381 570%
Evernorth Bh $213 - $343 607%
Western Plains Community Health $275 784%
Northcare $296 844%
Physician Health Partners $296 844%
Pinnacol Workers Comp $317 904%
Medical Development International $338 964%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals