Occupational therapy (therapeutic activities)
Facility: Harrison County Hospital
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $46
- Cash Discount Price: $83
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| Blue Cross Blue Shield | $18 - $226 | 51% |
| Aetna | $21 - $226 | 60% |
| Encore Encircle | $25 - $181 | 71% |
| Encore Ppo - All Other Plans | $25 - $203 | 71% |
| Cigna | $31 - $203 | 88% |
| Sagamore-All Plans | $31 - $181 | 88% |
| Tricare | $31 - $44 | 88% |
| UnitedHealthcare | $31 - $226 | 88% |
| Buckeye Exchange-All Plans | $33 - $78 | 94% |
| Caresource Mcaid Hhw | $33 - $226 | 94% |
| Caresource Mcaid Hip | $33 - $47 | 94% |
| Caresource Mcr Adv | $33 - $47 | 94% |
| Humana | $33 - $151 | 94% |
| Mdwise Mcaid Hhw/Hcc - All Other Plans | $33 - $226 | 94% |
| Mdwise Mcaid Hip | $33 - $47 | 94% |
| Mhs Exchange-All Other Plans | $33 - $47 | 94% |
| Mhs Mcaid Hhw/Hcc | $33 - $226 | 94% |
| Mhs Mcaid Hip | $33 - $47 | 94% |
| Passport Mcaid-All Other Plans | $33 - $47 | 94% |
| Passport Mcr Adv | $33 - $47 | 94% |
| Communicare Adv-All Plans | $34 - $48 | 97% |
| Mhs Mcr Adv | $34 - $48 | 97% |
| Caresource Exchange-All Other Plans | $35 - $62 | 100% |
| Siho Exchange | $35 - $49 | 100% |
| Siho One Southern | $35 - $113 | 100% |
| Siho Ppo/Hmo - All Other Plans | $35 - $181 | 100% |
| Beech Street Comm-All Plans | $42 - $192 | 120% |
| First Health-All Plans | $42 - $192 | 120% |
| Multiplan-All Plans | $45 - $203 | 128% |
| Passport Mcaid Beh Hlth | $56 | 160% |