Occupational therapy (therapeutic activities)
Facility: Northern Louisiana Medical Center
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $232
- Cash Discount Price: $150
- vs. Medicare Baseline: 6.62x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 662% of the Medicare baseline (a markup of 562%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Aetna | $9 - $164 | 26% |
| Blue Cross Blue Shield | $9 - $76 | 26% |
| Medicaid / KanCare | $9 - $273 | 26% |
| UnitedHealthcare | $9 - $164 | 26% |
| Humana | $10 - $43 | 29% |
| Champus | $27 | 77% |
| Champva | $27 | 77% |
| Tricare | $27 - $33 | 77% |
| Gulf South Services | $33 | 94% |
| Medicare (plans) | $33 | 94% |
| Mutual Of Omaha | $33 | 94% |
| Va | $33 | 94% |
| Vantage Advantage | $33 | 94% |
| Veterans Evaluation Svcs | $33 | 94% |
| First Health | $55 - $232 | 157% |
| Vantage Health Plan Ppaca | $64 | 182% |
| Vantage Health Plan | $67 | 191% |
| Golden Rule Ins | $102 - $164 | 291% |
| Verity Healthnet | $134 | 382% |
| Cigna | $136 | 388% |
| Kaiser Permanente | $136 | 388% |
| Gilsbar | $150 | 428% |
| Self Pay | $150 | 428% |
| Geha | $218 - $259 | 622% |
| Multiplan | $232 | 662% |
| Phcs | $232 | 662% |
| Work Comp City Of Ruston | $246 | 701% |
| Work Comp First Health | $246 | 701% |
| Work Comp Nlmc Emp | $246 | 701% |
| Workers Compensation | $246 | 701% |
| Aarp | $273 | 778% |
| Aflc American Family Life | $273 | 778% |
| American Life Accident | $273 | 778% |
| Apwu Health Plan | $273 | 778% |
| Bankers Life And Casualty | $273 | 778% |
| Benefit Trust Life | $273 | 778% |
| Crime Victims Compensatio | $273 | 778% |
| Equitable | $273 | 778% |
| Fox Everett Inc | $273 | 778% |
| Gmp Employers Retiree Tru | $273 | 778% |
| Gsu Athletics | $273 | 778% |
| Guarantee Trust Life Ins | $273 | 778% |
| Healthfirst Tpa | $273 | 778% |
| Hospice Of Caring Hearts | $273 | 778% |
| Ima Insurance | $273 | 778% |
| Industrial Accounts | $273 | 778% |
| Liberty Healthshare | $273 | 778% |
| Liberty Mutual Group | $273 | 778% |
| Lifecare Specialty Hosp | $273 | 778% |
| Lin Parish Detention | $273 | 778% |
| Lincoln Kidney Center | $273 | 778% |
| Ltu Athletics | $273 | 778% |
| Ltu Student Ins Bollinger | $273 | 778% |
| Mcr American Hlth Adv | $273 | 778% |
| Misc Commercial | $273 | 778% |
| Mva Insurance Payors | $273 | 778% |
| Nalc Health Benefit Plan | $273 | 778% |
| Nalc Natl Assoc Ltr Carri | $273 | 778% |
| Newera | $273 | 778% |
| Nlmc Community Services | $273 | 778% |
| Physicians Mutual Ins | $273 | 778% |
| Premier Hospice | $273 | 778% |
| Principal Mutual Life Ins | $273 | 778% |
| Protective Life Ins | $273 | 778% |
| Ruston Regional Specialty | $273 | 778% |
| Specialty Hosp Of Winnfie | $273 | 778% |
| State Farm Insurance | $273 | 778% |
| State Mutual Ins | $273 | 778% |
| Sterling Investors Life | $273 | 778% |
| The Hartford | $273 | 778% |
| Union Bankers Insurance C | $273 | 778% |
| Union Fidelity Life Ins | $273 | 778% |
| United American | $273 | 778% |
| United Teachers Ins | $273 | 778% |
| Us Dept Of Labor | $273 | 778% |
| Washington National Ins | $273 | 778% |