CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Baptist Memorial Hospital Union County

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $122
Cash Discount Price: $47
vs. Medicare Baseline: 3.48x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Baptist Memorial Hospital Union County is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 3.48x the Medicare baseline. Located in 200 Hwy 30 West, New Albany, MS.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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: $47 (134%)

Insurance Median: $122 (348%)

Cash: $47 (134% of Medicare)

Ins. Median: $122 (348% 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 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.

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
Aetna	$24 - $139	68%
Advanced Health Systems Inc.	$34	97%
Blue Cross Blue Shield	$34	97%
Magnolia Ms	$36 - $47	103%
Ppo Holdings	$66 - $84	188%
Magnolia Regional Health Center	$69 - $89	197%
Littler	$86 - $111	245%
Molina	$86 - $111	245%
Mpcn	$90 - $115	257%
Cigna	$95 - $122	271%
Primewell	$104 - $133	297%
Humana	$114 - $147	325%
First Choice Health Plan Of Ms	$121 - $155	345%
Multiplan	$130 - $166	371%
Novasys	$130 - $166	371%
Christian Health Aid	$138 - $178	393%
Ppo Plus	$147 - $189	419%
Qca	$156 - $200	445%
UnitedHealthcare	$160 - $237	456%

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 $47.
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 Baptist Memorial Hospital Union County 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.