Occupational therapy (therapeutic activities)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $66
- Cash Discount Price: $154
- vs. Medicare Baseline: 1.88x 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 |
|---|---|---|
| Medicaid / KanCare | $28 | 80% |
| Blue Cross Blue Shield | $63 - $66 | 180% |
| Tricare | $63 | 180% |
| Medicare (plans) | $66 | 188% |
| Aetna | $66 | 188% |
| Medadv_Allwell | $66 | 188% |
| Va_Ccn | $66 | 188% |
| Humana | $66 | 188% |
| Medadv_Uhc | $66 | 188% |
| Ambetter / Centene | $103 | 294% |
| Wppa_Providrscare | $170 | 485% |
| United | $171 | 488% |
| Coventry | $195 | 556% |
| Cigna | $195 | 556% |
| Hpk | $195 | 556% |
Consumer Guidance & Cost Commentary
For Occupational therapy (therapeutic activities) at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's cash median rate of $154.00 is significantly lower than the state average of $195.00, offering a potential savings opportunity for self-pay patients. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Tricare range between $63.00 and $66.00, these amounts are still higher than the cash price, illustrating that paying out-of-pocket can sometimes be more cost-effective for individuals with high-deductible plans or those without insurance. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives often bypass the administrative overhead that inflates insurance negotiated rates.
It is important to note that the facility's gross charge of $205.00 represents the maximum list price, which is substantially higher than both the cash and negotiated rates. Because this facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance contracts may not reflect the true cost of care, as evidenced by the Medicare benchmark rate of $35.07. If you receive a bill that includes the full gross charge or unexpected balance billing, you should request a detailed itemized audit to identify errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies. Furthermore, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, so any surprise charges should be disputed immediately with the insurer rather than paying the full amount upfront