CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Wyandotte Hospital and Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $47
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Wyandotte Hospital and Medical Center is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.34x the Medicare baseline. Located in 2333 Biddle Ave, Wyandotte, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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%)
Insurance Median: $47 (134%)
Ins. Median: $47 (134% 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.

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 $19 - $69 54%
Hap $19 - $54 54%
Mclaren $19 54%
Meridian Health Plan Of Mi $19 - $63 54%
Priority Health $19 - $84 54%
Molina $20 - $33 57%
Molina Mi Health Link $33 94%
Humana $34 97%
Wellcare $35 100%
Cofinity Group Health $41 - $62 117%
Cca Health Michigan $45 128%
Mclaren Health $47 134%
Blue Cross Blue Shield $54 - $57 154%
Vitalcore Physicians Group Of Mi $56 160%
UnitedHealthcare $69 197%
Multiplan, Inc. $74 211%
Cigna $75 214%
University Of Michigan $89 254%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2333 Biddle Ave, Wyandotte, MI 48192
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals