CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: PAM Rehabilitation Hospital of Tavares LLC

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $67
Cash Discount Price: $175
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at PAM Rehabilitation Hospital of Tavares LLC is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.91x the Medicare baseline. Located in 1730 Mayo Dr, Tavares, FL.

Cash / Self-Pay

$175

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $175 (499%)

Insurance Median: $67 (191%)

Cash: $175 (499% of Medicare)

Ins. Median: $67 (191% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$20 - $34	57%
Curative	$25	71%
Careplus	$32	91%
UnitedHealthcare	$32 - $75	91%
Humana	$33	94%
Palm Beach Aco Reach	$33	94%
Primary Care Alliance	$33	94%
Blue Cross Blue Shield	$34 - $88	97%
Ilumed Aco Reach	$34	97%
Simply Healthcare	$34	97%
Sunshine State Health Plan	$34	97%
Wellmed	$34	97%
Velocity Provider Ppo Network	$40 - $131	114%
Prime Health Services	$44 - $149	125%
America'S Choice Provider Network	$123	351%
Quik Trip	$131	374%
Usa Managed Care Organization	$131	374%
Orlando Health Network	$135	385%
Multiplan/Phcs	$140	399%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $175.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97530.

Insurance In-Network Protection Plan

Contact your insurance company to confirm PAM Rehabilitation Hospital of Tavares LLC is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97530.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.