CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Womans Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $64
Cash Discount Price: $511
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Womans Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $511. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.82x the Medicare baseline. Located in 100 Woman's Way, Baton Rouge, LA.

Cash / Self-Pay

$511

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $511 (1457%)

Insurance Median: $64 (182%)

Cash: $511 (1457% of Medicare)

Ins. Median: $64 (182% 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
Webtpa [100127]	$48 - $63	137%
Fmolhs Employees [100257]	$56	160%
UnitedHealthcare	$59 - $64	168%
Blue Cross Blue Shield	$63	180%
La Women'S Healthcare [100265]	$63	180%
Verity [100266]	$63	180%
Aetna	$64 - $75	182%
Cigna	$64 - $66	182%
Coventry [100010]	$64	182%
Ppo Plus [100259]	$64	182%
Beech Street [100260]	$68	194%
Multiplan [100258]	$70	200%
Private Health [100261]	$70	200%
Humana	$75	214%
Meritain [100063]	$75	214%

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 $511.
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 Womans 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.