CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Munson Healthcare Manistee Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $53
Cash Discount Price: $100
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Munson Healthcare Manistee Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.51x the Medicare baseline. Located in 1465 E Parkdale Ave, Manistee, MI.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $100 (285%)

Insurance Median: $53 (151%)

Cash: $100 (285% of Medicare)

Ins. Median: $53 (151% 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
Blue Cross Blue Shield	$17 - $59	48%
Mclaren Health Plan	$17 - $88	48%
Meridian	$17	48%
Molina	$17 - $36	48%
Priority Health	$17 - $93	48%
UnitedHealthcare	$17 - $106	48%
Aetna	$31 - $102	88%
Cofinity	$31 - $104	88%
Hap (Health Alliance Plan)	$33 - $94	94%
Humana	$33	94%
Medicare (plans)	$33	94%
Michigan Amish Medical Board	$33	94%
Northern Michigan Mennonite Group	$33	94%
Prime Health Services	$33 - $109	94%
Wellcare Meridian	$33	94%
Provider Network Of America	$47 - $100	134%
Asr/Physicians Care	$50 - $94	143%
Nomi Health	$53 - $94	151%
Employee Benefits Logistics	$57	163%
Hospice Of Michigan	$71	202%
Munson Hospice	$83 - $852	237%
Cigna	$85 - $93	242%
Enterprise Group Planning/Employee Benefits Plan	$94	268%
Medical Cost Savings Solution	$94	268%
Three Rivers Provider Network	$100	285%
Multiplan	$104	297%
Great West Healthcare	$106	302%

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 $100.
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 Munson Healthcare Manistee 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.