CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Miller County Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $61
Cash Discount Price: $41
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Miller County Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.74x the Medicare baseline. Located in 209 N Cuthbert Street, Colquitt, GA.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $41 (117%)

Insurance Median: $61 (174%)

Cash: $41 (117% of Medicare)

Ins. Median: $61 (174% 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
Wellcare	$20	57%
Aetna	$35 - $58	100%
Ambetter / Centene	$35 - $38	100%
Blue Cross Blue Shield	$35 - $69	100%
Choicecare	$35 - $65	100%
Humana	$35 - $62	100%
Integrated Health Plan	$52 - $58	148%
Great West	$56 - $62	160%
Coventry	$60 - $65	171%
Beech Street	$61 - $67	174%
Cigna	$61 - $67	174%
First Health/Hf	$63 - $69	180%
First Health/Ccn	$66 - $73	188%

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 $41.
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 Miller County Hospital 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.