CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Monroe Surgical Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $46
Cash Discount Price: $73
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Monroe Surgical Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.31x the Medicare baseline. Located in 2408 Broadmoor Blvd, Monroe, LA.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $73 (208%)

Insurance Median: $46 (131%)

Cash: $73 (208% of Medicare)

Ins. Median: $46 (131% 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
Healthy_Blue	$9	26%
Medicaid / KanCare	$9	26%
Aetna	$33 - $68	94%
Blue_Cross_Blue_Shield	$33 - $57	94%
Ford_Bacon_And_Davis	$33	94%
Humana	$33 - $57	94%
Medicare (plans)	$33	94%
UnitedHealthcare	$33 - $156	94%
Vantage	$33 - $57	94%
Verity	$35	100%
Insurance_Systems_Smso_Employee	$41	117%
Insurance_Systems	$46	131%
First_Health	$68	194%
Gilsbar	$70	200%
Cigna	$73	208%
Ima	$78	222%
Beech_St	$83	237%
Workers_Comp	$88	251%

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 $73.
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 Monroe Surgical 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.