CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Cherokee Regional Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $78
Cash Discount Price: $70
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Cherokee Regional Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 2.22x the Medicare baseline. Located in 300 Sioux Valley Drive, Cherokee, IA.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $70 (200%)

Insurance Median: $78 (222%)

Cash: $70 (200% of Medicare)

Ins. Median: $78 (222% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$41 - $78	117%
Blue Cross Blue Shield	$41 - $78	117%
Health Partners	$41 - $78	117%
Humana	$41 - $78	117%
UnitedHealthcare	$41 - $78	117%
Wellpoint	$41 - $78	117%
Iowa Total Care	$43 - $78	123%
Molina	$43 - $78	123%
Admin Concepts	$78	222%
American Republic	$78	222%
Apw	$78	222%
Auxiant	$78	222%
Avera	$78	222%
Bankers Life	$78	222%
Champus	$78	222%
Cigna	$78	222%
Liability	$78	222%
Meridian	$78	222%
Meritain	$78	222%
Midlands	$78	222%
Mutual Of Omaha	$78	222%
Occunet	$78	222%
Physicians Mutual	$78	222%
Private Healthcare	$78	222%
Sanford	$78	222%
United American	$78	222%

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 $70.
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 Cherokee Regional 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.