CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Neshoba County General Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $36
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Neshoba County General Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.03x the Medicare baseline. Located in 1001 Holland Ave, Philadelphia, MS.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $59 (168%)
Insurance Median: $36 (103%)
Cash: $59 (168% of Medicare)
Ins. Median: $36 (103% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Tricare $29 83%
Humana $32 91%
Magnolia Mcr Adv-All Other Plans $32 91%
Molina Comm-All Other Plans $32 91%
Molina Mcr Adv $32 91%
UnitedHealthcare $32 - $134 91%
Wellcare Mcr Adv-All Plans $32 91%
Magnolia Mcaid $33 94%
Molina Mcaid $33 94%
Mpcn Mcaid $33 94%
First Choice Comm Ip/Op Only - All Plans $40 114%
Aetna $42 120%
Ahs Ip/Op Only-All Plans $63 180%
Blue Cross Blue Shield $67 191%
Affordable Health Care-All Plans $71 202%
Health Choice Ip/Op Only-All Plans $71 202%
Health Link Ip/Op Only-All Plans $71 202%
Cigna $75 214%
Geha-All Plans $76 217%
Multiplan-All Plans $76 217%
Mpcn Ip/Op Only-All Other Plans $105 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1001 Holland Ave, Philadelphia, MS 39350
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - CRITICAL ACCESS HOSPITAL