CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Ochsner American Legion Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $32
Cash Discount Price: $25
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Ochsner American Legion Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 0.91x the Medicare baseline. Located in 1634 Elton Road, Jennings, LA.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $25 (71%)

Insurance Median: $32 (91%)

Cash: $25 (71% of Medicare)

Ins. Median: $32 (91% 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.

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
Aetna	$9 - $52	26%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$9	26%
Healthy Blue (Healthy Louisiana)	$9	26%
Humana	$9 - $32	26%
Louisiana Healthcare Connections (Healthy Louisiana)	$9	26%
UnitedHealthcare	$9 - $139	26%
Blue Cross Blue Shield	$32 - $80	91%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$32	91%
Medicare (plans)	$32	91%
Ochsner Health Plan	$32	91%
Wellcare Of Louisiana	$32	91%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$33	94%
Tricare	$34	97%
Verity Commercial And First Choice Network	$37	106%
Provider Network Of America	$55	157%
Zelis	$56	160%
Louisiana Workers' Compensation Corporation (Lwcc)	$60 - $908	171%
Healthcomp & Personify Health (Formerly Gilsbar)	$63	180%
Cigna	$100	285%

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 $25.
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 Ochsner American Legion 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.