Occupational therapy (therapeutic activities)
Facility: Merit Health Women's Hospital
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $50
- Cash Discount Price: $118
- vs. Medicare Baseline: 1.43x 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 |
|---|---|---|
| Medicaid / KanCare | $9 - $29 | 26% |
| UnitedHealthcare | $28 - $160 | 80% |
| Caresource Truecare | $29 | 83% |
| Magnolia Mcd Ms Chip | $29 | 83% |
| Tricare | $30 | 86% |
| Molina Chip | $31 | 88% |
| Humana | $32 | 91% |
| Medicare (plans) | $32 | 91% |
| Node Champva | $32 | 91% |
| Node Devoted Health Mcr Adv | $32 | 91% |
| Node First Choice American Health Of Ms Mcr Adv | $32 | 91% |
| Node Molina Mcr Adv | $32 | 91% |
| Node Shared Health Of Ms Mcr Adv | $32 | 91% |
| Node Va | $32 | 91% |
| Node Vantage Health Mcr Adv | $32 | 91% |
| Node Windsor Mcr Adv | $32 | 91% |
| Veterans Eval Services | $32 | 91% |
| Aetna | $33 - $368 | 94% |
| Node First Choice Wellcare Mcr Adv | $33 | 94% |
| Advanced Health Systems | $34 | 97% |
| Node Healthy Mississippi Mcr Adv | $35 | 100% |
| Blue Cross Blue Shield | $40 | 114% |
| First Choice Preferred | $48 | 137% |
| Occunet | $48 | 137% |
| Node Us Dept Of Labor | $52 | 148% |
| Node First Choice Seven Corners | $55 | 157% |
| Magnolia Exchange | $56 | 160% |
| Ms Work Comp | $61 | 174% |
| Molina Exchange | $62 | 177% |
| First Choice Lgp | $70 | 200% |
| Vantage Health | $72 | 205% |
| Cigna | $114 | 325% |
| Self Pay | $116 | 331% |
| Trimed Billing Solutions | $158 | 451% |
| State Hospital | $200 | 570% |
| First Choice Mpcn | $236 | 673% |
| First Choice Standard | $242 | 690% |
| Coventry First Health | $273 | 778% |
| First Choice Ppo Plus | $289 | 824% |
| Benefit Management Systems | $378 - $446 | 1078% |
| First Choice Stratose | $420 | 1198% |
| Health Choice Of Mississippi | $420 | 1198% |
| Prime Health Services | $420 | 1198% |
| Mississippi Department Of Rehabilitation Services | $525 | 1497% |