Occupational therapy (therapeutic activities)
Facility: Mercy Hospital Southeast
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $40
- Cash Discount Price: $137
- vs. Medicare Baseline: 1.14x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $14 - $135 | 40% |
| Medicaid / KanCare | $14 - $55 | 40% |
| Auxiant Contracted [320462] | $31 - $62 | 88% |
| Blue Cross Blue Shield | $31 - $200 | 88% |
| Cross Timbers Hospice [20098] | $31 | 88% |
| Dept Of Veteran Affairs Contracted [320106] | $31 | 88% |
| Elara Caring Aspire Hospice Contracted [320433] | $31 | 88% |
| Elara Caring Aspire Hospice [20433] | $31 | 88% |
| Halo Hcr Inc Hospice Contracted [320432] | $31 | 88% |
| Halo Hcr Inc Hospice [20432] | $31 | 88% |
| Healthlink Contracted [320179] | $31 - $220 | 88% |
| Humana | $31 - $179 | 88% |
| Imagine 360 Contracted [320494] | $31 | 88% |
| Kindful Hospice Contracted [320434] | $31 | 88% |
| Kindful Hospice [20434] | $31 | 88% |
| Medicare (plans) | $31 - $33 | 88% |
| Mercy Benefit Admin Contracted [320251] | $31 - $143 | 88% |
| Mercy Hospice Okc [20252] | $31 | 88% |
| Pace Of The Ozarks Contracted [320518] | $31 | 88% |
| Tricare | $31 | 88% |
| Ambetter / Centene | $32 | 91% |
| American Health Advantage Of Mo Mcr Hmo Contracted [320264] | $32 | 91% |
| Home State Health Plan Contracted [320187] | $32 | 91% |
| Hope Trust Contracted [320488] | $32 | 91% |
| UnitedHealthcare | $32 - $47 | 91% |
| United Medical Resources Contracted [320454] | $35 | 100% |
| Provider Partners Health Plans Contracted [320450] | $36 | 103% |
| Consociate Consolidated Health Contracted [320490] | $44 - $70 | 125% |
| Centivo Contracted [320505] | $52 | 148% |
| Ebms Contracted [320493] | $52 | 148% |
| Preferred Health Plan Contracted [320522] | $56 | 160% |
| Reflect Health Contracted [320492] | $58 | 165% |
| First Health Contracted [320128] | $135 | 385% |
| Health Alliance Contracted [320164] | $137 | 391% |
| Aither Health Contracted [320449] | $143 | 408% |
| Edison Health Solutions Contracted [320502] | $143 | 408% |
| Mercy Benefit Admin [20251] | $143 | 408% |
| Yuzu Health Contracted [320521] | $143 | 408% |
| Workers Comp [20426] | $158 - $169 | 451% |
| Multiplan Contracted [320270] | $169 | 482% |
| Private Health Care Systems Contracted [320320] | $169 | 482% |
| Cigna | $286 | 816% |