CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Saint Joseph Hospital

Billing Code: 97530 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$110
about 3.1× the $35 Medicare rate · typically $36–$159
modeled estimate · not a bill or quote
What this hospital charges insurers
$112
About the fair price
about $2 over the fair price · 3.2× Medicare
Medicare pays $35 Fair price $110 This hospital $112 Cash price $79 Hospital's list price $162

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $22 Priciest $112

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

A fair price for a Occupational therapy (therapeutic activities) is about $110 (about 3.1× the $35 Medicare rate). Saint Joseph Hospital charges insurers about $112, or about $79 in cash — about the fair price. Located in Lexington, KY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $42 - $133 120%
Blue Cross Blue Shieldmajor $43 - $52 123%
Aetnamajor $41 - $128 117%
Cignamajor $102 - $125 291%
Humanamajor $40 - $100 114%
Molina $36 - $43 103%
WellCare $43 - $51 123%
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: One Saint Joseph Drive, Lexington, KY 40504
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals