CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Acadian Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $98
Cash Discount Price: $63
vs. Medicare Baseline: 2.79x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Acadian Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 2.79x the Medicare baseline. Located in 3501 Highway 190 East, Eunice, LA.

Cash / Self-Pay

$63

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $63 (180%)

Insurance Median: $98 (279%)

Cash: $63 (180% of Medicare)

Ins. Median: $98 (279% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 279% of the Medicare baseline (a markup of 179%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 - $40	26%
Mcd Hmo Amerigroup	$9 - $40	26%
Mcd Hmo La Care	$9 - $40	26%
Mcd Hmo La Hlth Cr Connct	$9 - $40	26%
Medicaid / KanCare	$9 - $210	26%
UnitedHealthcare	$9 - $40	26%
Mcd Hmo Com Hlth Solution	$10 - $44	29%
Tricare	$26 - $33	74%
Medicare (plans)	$33 - $210	94%
Pp0/Manged Care	$33 - $210	94%
Ppo/Manged Care	$33 - $210	94%
Charity/Map	$63 - $210	180%
Blue Cross Blue Shield	$71	202%
American Postal Workers	$134	382%
Work Comp	$189	539%
Auto Insurance	$210	599%
Bankers Fidelity	$210	599%
Commerical	$210	599%
Commerical Ip	$210	599%
Industrial	$210	599%
Mra Auto/Liability	$210	599%

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 $63.
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 Acadian Medical Center 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.