Occupational therapy (therapeutic activities)
Facility: Mercy Rehabilitation Hospital Springfield
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $122
- Cash Discount Price: $122
- vs. Medicare Baseline: 3.48x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 348% of the Medicare baseline (a markup of 248%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $73 - $122 | 208% |
| Blue Preferred | $88 | 251% |
| Firsthealth Network | $89 | 254% |
| Blue Cross Blue Shield | $93 - $122 | 265% |
| Healthlink Workcomp | $104 | 297% |
| Allwell From Home State Health | $122 | 348% |
| Allyalign Health (Nhc Advantage) | $122 | 348% |
| Ambetter / Centene | $122 | 348% |
| Architectural Systems, Inc. (Asi) | $122 | 348% |
| Ava R1 School District (Smbc) | $122 | 348% |
| Bakersfield School District (Smbc) | $122 | 348% |
| Blue Access | $122 | 348% |
| Bolivar School (Smbc) | $122 | 348% |
| Buchheit | $122 | 348% |
| Cardinal Scale (Tri State Healthcare Coalition) | $122 | 348% |
| Carthage R-9 School District (Tri-State Healthcare Coalition) | $122 | 348% |
| Cigna | $122 | 348% |
| City Of Springfield | $122 | 348% |
| City Of Webb City (Tri State Healthcare Coalition) | $122 | 348% |
| Devoted Healthcare | $122 | 348% |
| Diversified Plastics | $122 | 348% |
| Dora School District (Smbc) | $122 | 348% |
| Easter Seals Midwest | $122 | 348% |
| Employers Benefit Alliance | $122 | 348% |
| Essence | $122 | 348% |
| Evolutions | $122 | 348% |
| Fabick Cat | $122 | 348% |
| Fair Grove School District (Smbc) | $122 | 348% |
| Health Net Federal Services | $122 | 348% |
| Health Systems, Inc. | $122 | 348% |
| Healthlink Hmo | $122 | 348% |
| Healthlink Ppo | $122 | 348% |
| Heart Of America (Tri State Healthcare Coalition &Amp;#8211; Med Pay) | $122 | 348% |
| Hickory County Skyline School District (Smbc) | $122 | 348% |
| Home State Health Plan, Inc. | $122 | 348% |
| Humana | $122 | 348% |
| J And M Farms, Inc. (Tri-State Healthcare Coalition) | $122 | 348% |
| Jayhawk Fine Chemicals/Evonic(Tri State Healthcare Coalition) | $122 | 348% |
| Laclede County School District Conway (Smbc) | $122 | 348% |
| Lebanon School District (Smbc) | $122 | 348% |
| Liberty Utilities (Empire District Electric) | $122 | 348% |
| Marshfield School District (Smbc) | $122 | 348% |
| Medica | $122 | 348% |
| Medicaid / KanCare | $122 | 348% |
| Mercy Charity Contract | $122 | 348% |
| Mers Goodwill | $122 | 348% |
| Missouri State University | $122 | 348% |
| Mount Vernon School District (Smbc) | $122 | 348% |
| Mountain Grove R-111 School District (Smbc) | $122 | 348% |
| Mountain View School District (Smbc) | $122 | 348% |
| Multiplan/Phcs/Beech Street | $122 | 348% |
| Ozarks Community Hospital | $122 | 348% |
| Pathway/Pathway X | $122 | 348% |
| Phcs Savility | $122 | 348% |
| Quality Collisson Group | $122 | 348% |
| Quiktrip Corporation | $122 | 348% |
| Richards R-V School District (Smbc) | $122 | 348% |
| Roper Automotive Group (Tri State Healthcare Coalition) | $122 | 348% |
| S And H Farm Supply | $122 | 348% |
| Schreiber Foods | $122 | 348% |
| Shinesolar | $122 | 348% |
| Springfield Public Schools | $122 | 348% |
| Springfield Remanufacturing | $122 | 348% |
| Trailiner | $122 | 348% |
| UnitedHealthcare | $122 | 348% |
| Webb City R-Vii School District (Tri-State Healthcare Coalition) | $122 | 348% |
| Wellcare Health Plans | $122 | 348% |
| Woodard Cleaning &Amp;#038; Restoration, Inc. | $122 | 348% |