CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Deaconess Henderson Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $47
  • Cash Discount Price: $61
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Deaconess Henderson Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.34x the Medicare baseline. Located in 1305 N Elm St, Henderson, KY.
Cash / Self-Pay
$61

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$35.07

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $35.07 (100%)
Cash / Self-Pay: $61 (174%)
Insurance Median: $47 (134%)
Cash: $61 (174% of Medicare)
Ins. Median: $47 (134% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 - $34 51%
Aetna $22 - $198 63%
Humana $22 - $163 63%
Medicaid / KanCare $22 - $41 63%
UnitedHealthcare $22 - $131 63%
Wellcare Ky $22 - $32 63%
Wellcare Il $24 - $32 68%
Ky Racing Health & Welfare Fund $27 - $59 77%
Self-Pay $27 - $61 77%
Medicare (plans) $32 91%
Mhs Mco $32 91%
Molina Healthcare Of Ky $32 91%
Molina Healthcare Of Ky - Exchange $32 91%
Mytru Advantage $32 - $59 91%
Umwa $32 91%
Alliance Coal $33 - $50 94%
Caresource In $34 97%
Caresource In Marketplace $41 117%
Wellcare Ky Commercial Exchange $41 117%
Center Care Narrow $43 - $171 123%
Center Care Open Access $43 - $171 123%
Encircle/Encore Combined $45 - $118 128%
Encircle/Encore Prime $45 - $110 128%
Cigna $47 - $131 134%
Claimdoc $47 - $122 134%
Hopetrust $47 134%
Hstechnology $47 - $122 134%
First Health Network (Coventry) $49 - $173 140%
Healthlink $49 - $153 140%
Iu Health Plans $49 - $105 140%
Phcs/Multiplan $49 - $171 140%
Sagamore $49 - $180 140%
Amish And Mennonite Of Western Ky $50 - $51 143%
Noncontracted $50 143%
Coventry National Network $62 - $163 177%
Webster County Detention Center $62 - $163 177%
One Care $67 191%
Henderson County Detention Center $70 - $184 200%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 N Elm St, Henderson, KY 42420
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals