CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: HCA Florida Raulerson Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $37
  • Cash Discount Price: $616
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at HCA Florida Raulerson Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $616. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.06x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
$616

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $616 (1756%)
Insurance Median: $37 (106%)
Cash: $616 (1756% of Medicare)
Ins. Median: $37 (106% 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 $30 - $34 86%
Devoted Health $30 - $34 86%
Humana $30 - $246 86%
Ndms Definitive Care $30 - $34 86%
United $30 - $277 86%
Veterans Evaluation Services $30 - $34 86%
Wellmed $30 - $34 86%
Aetna $31 - $185 88%
Blue Cross Blue Shield $31 - $35 88%
Ultimate Health Plan $31 - $35 88%
American Health Plan $32 - $36 91%
Cigna $32 - $216 91%
Florida Complete Care $32 - $37 91%
Prominence Healthfirst $32 - $36 91%
Sunshine State $32 - $38 91%
Centurion $33 - $38 94%
Amerihealth Caritas $36 - $41 103%
Longevity Health Plan $36 - $41 103%
Corvel Corporation $41 117%
Careworks (Rockport) $42 120%
Prime Health $42 120%
Solis Health Plan $44 - $50 125%
Freedom Health $53 - $99 151%
Optimum $53 151%
Avmed $80 - $308 228%
Simply Healthcare Plans $80 228%
Molina $117 - $166 334%
Oscar $117 334%
Health Sun Health Plan $131 374%
Simply Healthcare $145 413%
Sunshine State Health Plan $157 448%
United Ppo $271 773%
Plotkin Health $308 878%
Prime Health Sherriff $308 878%
Multiplan $462 - $524 1317%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals