CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Mc Donough District Hospital

Billing Code: 97530 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$32
about 0.9× the $35 Medicare rate · typically $29–$35
modeled estimate · not a bill or quote
What this hospital charges insurers
$33
About the fair price
about $1 over the fair price · 0.9× Medicare
Medicare pays $35 Fair price $32 This hospital $33

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

A typical price — 0 charge more and 3 charge less, among the 9 IL hospitals compared.

Cheapest $24 Priciest $33

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

A fair price for a Occupational therapy (therapeutic activities) is about $32 (about 0.9× the $35 Medicare rate). Mc Donough District Hospital charges insurers about $33 — about the fair price. Located in Macomb, IL.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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 $32 - $33 91%
Blue Cross Blue Shieldmajor $45 128%
Aetnamajor $33 - $45 94%
Humanamajor $33 - $45 94%
Meridian $33 94%
Molina $33 94%
+ 3 smaller / regional plans $20 - $33
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals