CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Atrium Health Floyd Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $59
Cash Discount Price: $65
vs. Medicare Baseline: 1.68x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Atrium Health Floyd Medical Center is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.68x the Medicare baseline. Located in 304 Turner McCall Boulevard, Rome, GA.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $65 (185%)

Insurance Median: $59 (168%)

Cash: $65 (185% of Medicare)

Ins. Median: $59 (168% 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
Amerigroup	$22	63%
Caresource	$22 - $48	63%
Peach State Health Plan	$22	63%
Awc Networks	$25	71%
Oscar Health Plan	$25 - $46	71%
Blue Cross Blue Shield	$32 - $98	91%
Cigna	$32 - $250	91%
Georgia Assurance	$32	91%
Humana	$32 - $84	91%
UnitedHealthcare	$32 - $98	91%
Aetna	$33 - $88	94%
Clover	$33	94%
Wellcare	$33	94%
Alliant Health Plans	$48 - $52	137%
Ambetter / Centene	$48	137%
Beacon	$65	185%
Evernorth	$65	185%
Multiplan	$91	259%
Occunet	$100	285%
Beech Street	$101	288%
Private Health Care Systems	$110	314%

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 $65.
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 Atrium Health Floyd Medical Center 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.