Occupational therapy (therapeutic activities)
Facility: Lutheran Hospital of Indiana
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $65
- Cash Discount Price: $43
- vs. Medicare Baseline: 1.85x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ky Work Comp | $22 - $46 | 63% |
| Physicians Health Plan Of Northern Indiana | $22 - $72 | 63% |
| Theramatrix | $24 | 68% |
| Amish Aid | $27 - $55 | 77% |
| Lutheran Preferred Network | $27 - $109 | 77% |
| Self Pay | $27 - $66 | 77% |
| Cigna | $29 - $66 | 83% |
| Php Freedom Network | $30 - $71 | 86% |
| UnitedHealthcare | $30 - $186 | 86% |
| Tricare | $31 | 88% |
| Aetna | $33 - $87 | 94% |
| Blue Cross Blue Shield | $33 - $186 | 94% |
| Department Of Veterans Affairs | $33 | 94% |
| Humana | $33 - $186 | 94% |
| Iu Health Plan | $33 | 94% |
| Managed Health Services | $33 - $186 | 94% |
| Medicare (plans) | $33 | 94% |
| Node Hospice Non Par Agree | $33 | 94% |
| Node Va | $33 | 94% |
| One Call Care Diagnostics | $33 | 94% |
| Veterans Eval Services | $33 | 94% |
| Node Devoted Health Mcr Adv | $34 | 97% |
| In Dept Of Correction | $35 | 100% |
| Node Pphp Mcr Adv | $35 | 100% |
| Lutheran Preferred | $36 - $73 | 103% |
| Sagamore | $41 - $95 | 117% |
| Encore Ppo | $44 - $89 | 125% |
| Lutheran Network | $44 - $91 | 125% |
| Lutheran Advanced Network | $50 | 143% |
| Node Lutheran Network | $50 - $59 | 143% |
| Node Lutheran Preferred Fixed 2 | $50 | 143% |
| Align Network | $54 | 154% |
| Us Department Of Labor | $54 | 154% |
| Encore Work Comp In | $60 | 171% |
| Prime Health Services | $60 - $136 | 171% |
| Multiplan | $65 - $151 | 185% |
| Encore Health Network | $73 - $164 | 208% |
| Advantage Health Solutions | $74 - $151 | 211% |
| Allied Benefit Systems | $80 - $164 | 228% |
| Evolutions | $80 - $164 | 228% |
| Node Encore Kba Epo | $80 | 228% |
| Node Encore Kba Ppo | $100 | 285% |
| Care Source | $186 | 530% |
| Medicaid / KanCare | $186 | 530% |