CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: University of Louisville Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $78
Cash Discount Price: $36
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at University of Louisville Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 2.22x the Medicare baseline. Located in 530 South Jackson Street, Louisville, KY.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $36 (103%)

Insurance Median: $78 (222%)

Cash: $36 (103% of Medicare)

Ins. Median: $78 (222% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$20 - $181	57%
Aetna	$21 - $30	60%
Cshn	$21 - $181	60%
Humana	$21 - $32	60%
Passport	$21 - $90	60%
UnitedHealthcare	$21 - $86	60%
Essence Health	$32	91%
Va Ccn	$32	91%
Signature	$33 - $90	94%
Communicare	$34	97%
Devoted	$34 - $54	97%
Prime Group Health	$34 - $154	97%
Senior Care Community Of Ky	$34	97%
Wellcare	$37 - $48	106%
Key Benefit Administrators	$42	120%
Velocity	$42 - $177	120%
Multiplan	$81 - $163	231%
Encore	$85 - $127	242%
Health Smart	$92 - $136	262%
Cigna	$102	291%
Omca	$116 - $172	331%
Corvel	$122 - $181	348%
National Comp Care	$122 - $181	348%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $36.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97530.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Louisville Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97530.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.