CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Northside Hospital Duluth

Billing Code: 97530 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$45
about 1.3× the $35 Medicare rate · typically $35–$73
modeled estimate · not a bill or quote
What this hospital charges insurers
$53
Above the fair price
about $8 over the fair price · 1.5× Medicare
Medicare pays $35 Fair price $45 This hospital $53 Cash price $226 Hospital's list price $301

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $20 Priciest $53

Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Occupational therapy (therapeutic activities) is about $45 (about 1.3× the $35 Medicare rate). Northside Hospital Duluth charges insurers about $53, or about $226 in cash — above the fair price. Located in Duluth, GA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $45. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $34 - $175 97%
Blue Cross Blue Shieldmajor $34 - $210 97%
Aetnamajor $34 - $205 97%
Cignamajor $46 - $190 131%
Humanamajor $34 - $35 97%
Kaiser Permanentemajor $35 - $262 100%
Ambetter (Centene) $38 - $141 108%
Amerigroup $38 - $54 108%
CareSource $35 - $112 100%
Clover Health $36 103%
Health Net $187 533%
Oscar Health $141 402%
WellCare $35 100%
+ 22 smaller / regional plans $34 - $301
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals