CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Charlevoix Area Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $65
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Charlevoix Area Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.85x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $69 (197%)
Insurance Median: $65 (185%)
Cash: $69 (197% of Medicare)
Ins. Median: $65 (185% 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
Blue Cross Blue Shield $24 - $75 68%
Mclaren Health Plan $24 - $75 68%
Meridian $24 68%
Priority Health $24 - $85 68%
UnitedHealthcare $24 - $70 68%
Aetna $33 - $73 94%
Blue Care Network $33 - $38 94%
Hap (Health Alliance Plan) $33 - $65 94%
Medicare (plans) $33 - $38 94%
Michigan Amish Medical Board $33 - $38 94%
Molina $33 - $41 94%
Northern Michigan Mennonite Group $33 - $38 94%
Provider Network Of America/Hma Group Health $47 - $69 134%
Hospice Of Michigan $49 140%
Asr Physicians Care Network $50 - $65 143%
Nomi Health $53 - $75 151%
Employee Benefits Logistics $57 - $65 163%
Enterprise Group Planning Employee Benefit Plan $65 185%
First Health/Coventry Health/Community Care Network $65 185%
Medical Cost Savings Solution $65 185%
Three Rivers Provider Network $69 197%
Cofinity $75 214%
Iba Health And Life Assurance Company $75 214%
Preferred Medical Claim Solutions $77 220%
Cigna $81 - $85 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 14700 Lakeshore Drive, Charlevoix, MI 49720
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals