CMS Price Transparency Data
Occupational therapy (therapeutic activities)
Facility: Avoyelles Hospital
Billing Code: 97530 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97530
- Insurance Median: $59
- Cash Discount Price: $28
- vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Avoyelles Hospital is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.68x the Medicare baseline. Located in 4231 Highway 1192, Marksville, LA.
Cash / Self-Pay
$28
Average discount available for prompt cash payment at this facility.
Insurance Median
$59
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: $28 (80%)
Insurance Median: $59 (168%)
Cash: $28 (80% of Medicare)
Ins. Median: $59 (168% 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
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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 - $53 | 26% |
| Cigna | $9 - $52 | 26% |
| Correct Cr Int Hlt | $9 - $19 | 26% |
| Mcd Amerihealth Caritas | $9 - $19 | 26% |
| Mcd Healthy Blue | $9 - $19 | 26% |
| Mcd La Hc Conn | $9 - $19 | 26% |
| Medicaid / KanCare | $9 - $19 | 26% |
| UnitedHealthcare | $9 - $33 | 26% |
| Mcd Ms | $10 - $21 | 29% |
| All Savers | $26 | 74% |
| Geha | $26 | 74% |
| United Hlth One | $26 | 74% |
| Student Assurances | $28 - $92 | 80% |
| Humana | $31 - $52 | 88% |
| Bankers Life | $33 | 94% |
| Champva | $33 | 94% |
| Mcr Lagniappe | $33 | 94% |
| Medeico Ins Co | $33 | 94% |
| Medicare (plans) | $33 | 94% |
| Mmc Allwell | $33 | 94% |
| Mmc Blue Advantage | $33 | 94% |
| Mmc Healthy Blue Dual Adv | $33 | 94% |
| Mmc Mcr Hmo Miscellaneous | $33 | 94% |
| Mmc Priority Hlth Pffs | $33 | 94% |
| Mmc Vantage Hlth | $33 | 94% |
| Mmc Wellcare | $33 | 94% |
| Mutual Of Omaha | $33 | 94% |
| Neba Inc | $33 | 94% |
| Philadelphia American Lif | $33 | 94% |
| Sentinel Security Life | $33 | 94% |
| Trustmark Health Benefits | $33 - $92 | 94% |
| Tunica Biloxi | $33 - $92 | 94% |
| United Amer Ins | $33 | 94% |
| Veterans Evaluation Serv | $33 | 94% |
| Wps Vacca | $33 | 94% |
| Amer Contl Ins | $43 - $53 | 123% |
| Coventry | $43 - $53 | 123% |
| First Choice Health | $43 - $53 | 123% |
| Gulf South Zelis | $43 | 123% |
| Meritan Health | $43 - $92 | 123% |
| Ppo Plus Llc | $56 | 160% |
| Zelis Healthcare Bpa | $56 | 160% |
| Gilsbar | $58 | 165% |
| Blue Cross Blue Shield | $59 | 168% |
| Ofc Of Grp Bene | $59 | 168% |
| Amerind | $83 | 237% |
| Applied Underwriters | $83 | 237% |
| Sedgwick | $83 | 237% |
| Us Dept Of Labor | $83 | 237% |
| Wc Clms Admin Svcs | $83 | 237% |
| Wc Clms Mgmnt Walmart | $83 | 237% |
| Wc Esis | $83 | 237% |
| Wc Fara | $83 | 237% |
| Wc Gallagher Bassett | $83 | 237% |
| Wc Guide One | $83 | 237% |
| Wc Hartford Med | $83 | 237% |
| Wc Luba | $83 | 237% |
| Wc Lwcc | $83 | 237% |
| Wc Paragon Casino Resort | $83 | 237% |
| Wc Risk Mgmnt | $83 | 237% |
| Wc Stone Trust | $83 | 237% |
| Wc Summit Consulting Hold | $83 | 237% |
| Wc Travelers Ins | $83 | 237% |
| Wc Trs Workers Comp Claim | $83 | 237% |
| Wc Us Dol | $83 | 237% |
| Wc Zurich | $83 | 237% |
| Aarp | $92 | 262% |
| Admin Concepts | $92 | 262% |
| All Saints Hospice | $92 | 262% |
| All State | $92 | 262% |
| Allegiance Health Hospice | $92 | 262% |
| Allied Natl | $92 | 262% |
| Amfirst | $92 | 262% |
| Avoy Parish School Board | $92 | 262% |
| Avoyelles Parish Sheriff | $92 | 262% |
| Bollinger | $92 | 262% |
| Ccmsi | $92 | 262% |
| Central States | $92 | 262% |
| Christus Health Plan | $92 | 262% |
| Compassionate Care Hospic | $92 | 262% |
| Core Source | $92 | 262% |
| Coushatta Hlth Dept | $92 | 262% |
| Ebms | $92 | 262% |
| Federated Ins | $92 | 262% |
| Feedom Life | $92 | 262% |
| Fidelity Standard Life Co | $92 | 262% |
| Fox Everette | $92 | 262% |
| Guarantee Trust | $92 | 262% |
| Heart Of Hospice | $92 | 262% |
| Hos Christus Hospice | $92 | 262% |
| Hos Guardian Hospice Care | $92 | 262% |
| Hos Harbor Hospice Alex | $92 | 262% |
| Hos La Hospice Palliative | $92 | 262% |
| Hos Passages Hospice N. | $92 | 262% |
| Hos St Joseph Hospice | $92 | 262% |
| Hospice Miscellaneous | $92 | 262% |
| Ins Mgmnt Admin | $92 | 262% |
| Ins Tpa | $92 | 262% |
| Liberty Health Share | $92 | 262% |
| Lumico | $92 | 262% |
| Manhattan Life Ins | $92 | 262% |
| Medi Share | $92 | 262% |
| Misc Comm | $92 | 262% |
| Nalc | $92 | 262% |
| New Era Life | $92 | 262% |
| North American | $92 | 262% |
| Phcs | $92 | 262% |
| Physicians Mutual | $92 | 262% |
| Pipeline Ind Bene | $92 | 262% |
| Progressive Auto | $92 | 262% |
| Reliance Standard Life | $92 | 262% |
| Rural Carriers | $92 | 262% |
| Shelter Ins Co | $92 | 262% |
| Sierre Health And Life | $92 | 262% |
| State Farm | $92 | 262% |
| State Mutual | $92 | 262% |
| Sterling Investors | $92 | 262% |
| The Health Plan | $92 | 262% |
| Tribal Hlth Partners | $92 | 262% |
| Tricare | $92 | 262% |
| Uct | $92 | 262% |
| Unified Life | $92 | 262% |
| Usaa Life Ins | $92 | 262% |
| Web-Tpa | $92 | 262% |
| Woodmen Of The World | $92 | 262% |