CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Atrium Health Navicent Peach

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $47
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Atrium Health Navicent Peach is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.34x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $44 (125%)
Insurance Median: $47 (134%)
Cash: $44 (125% of Medicare)
Ins. Median: $47 (134% 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
Aetna $18 - $52 51%
Blue Cross Blue Shield $18 - $68 51%
Georgia Health Advantage $18 - $37 51%
Humana $18 - $75 51%
Pruitt Health $18 - $39 51%
UnitedHealthcare $18 - $64 51%
Care Source $19 - $38 54%
Clover $19 - $38 54%
Eon Health $19 - $38 54%
Ambetter / Centene $26 - $45 74%
Alliant $39 - $43 111%
Cigna $39 - $64 111%
Securehealth $50 - $57 143%
Multiplan $57 - $70 163%
Novanet $70 200%
Three Rivers Provider Network $75 214%
Beechstreet $82 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1960 Highway 247 Connector, Byron, GA 31008
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals