CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Parkland Health Center - Bonne Terre

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $123
Cash Discount Price: $100
vs. Medicare Baseline: 3.51x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Parkland Health Center - Bonne Terre is $123. 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 3.51x the Medicare baseline. Located in 7245 Raider Road, Bonne Terre, MO.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $123 (351%)

Cash: $100 (285% of Medicare)

Ins. Median: $123 (351% 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 351% of the Medicare baseline (a markup of 251%). 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
Medica [662]	$35	100%
Aetna	$76 - $124	217%
Healthlink [225]	$81 - $125	231%
Cox Health Systems Insurance Company [220]	$91 - $123	259%
Health Alliance [224]	$91	259%
Allied Benefits [498]	$96 - $123	274%
Hope Trust [806]	$96	274%
Coresource [497]	$100	285%
Fmh Benefit Service Inc [222]	$100	285%
Mail Handlers [495]	$100	285%
Cigna	$103 - $133	294%
Healthscope Benefits [258]	$108 - $112	308%
Med-Pay [480]	$108 - $124	308%
Unicare [568]	$108 - $125	308%
Humana	$110	314%
UnitedHealthcare	$112 - $123	319%
Apwu Health Plan [216]	$117	334%
Nalc Health Benefit Plan [242]	$117	334%
Priority Health [648]	$117	334%
First Health Commercial [734]	$123	351%
Beechstreet [551]	$124	354%
Detego Health [868]	$124	354%
Health Systems Inc [620]	$124	354%
Healthcare Sol Mercy [609]	$124	354%
Multiplan Commercial [737]	$124	354%
Multiplan [240]	$124	354%
Phcs [244]	$124 - $133	354%
Preferred Health Professionals [561]	$125	356%
Hfn [563]	$133	379%
Medica [661]	$133	379%
Blue Cross Blue Shield	$141 - $211	402%
Consociate [478]	$227	647%
Sarah Bush Lincoln [636]	$227	647%

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 Parkland Health Center - Bonne Terre 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.