CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Jay Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $46
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Jay Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.31x the Medicare baseline. Located in 14114 Alabama St, Jay, FL.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $15 (43%)
Insurance Median: $46 (131%)
Cash: $15 (43% of Medicare)
Ins. Median: $46 (131% 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
Wellcare $10 - $29 29%
Aetna $15 - $64 43%
Bc Fl $15 - $29 43%
Humana $15 - $46 43%
UnitedHealthcare $15 - $223 43%
Cha Health Plan $23 66%
Simply Healthcare Healthy Kids $23 66%
Staywell $24 68%
Sunshine Health $24 68%
Hospice Emerald Coast $34 - $66 97%
Hospice Regency $34 - $66 97%
Hospice Vitas $34 - $66 97%
Cigna $37 - $133 106%
Fl Community Care Ltc $37 106%
Private Healthcare $44 - $86 125%
First Health $48 - $94 137%
Medicare (plans) $48 137%
Wc Corvel $48 - $126 137%
Multiplan $60 - $118 171%
Fl Blue $94 - $293 268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 14114 Alabama St, Jay, FL 32565
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals