CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Parkland Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $151
Cash Discount Price: $285
vs. Medicare Baseline: 4.31x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Parkland Medical Center is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 4.31x the Medicare baseline. Located in 1 Parkland Drive, Derry, NH.

Cash / Self-Pay

$285

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $285 (813%)

Insurance Median: $151 (431%)

Cash: $285 (813% of Medicare)

Ins. Median: $151 (431% 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 431% of the Medicare baseline (a markup of 331%). 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
Amerihealth Caritas	$8 - $11	23%
Well Sense Health Plan	$20 - $27	57%
John Hancock	$25 - $29	71%
Blue Cross Blue Shield	$32 - $157	91%
Cigna	$32 - $37	91%
Evernorth Behavioral Health	$32 - $37	91%
Humana	$32 - $36	91%
United	$32 - $218	91%
United Behavioral Health	$32 - $36	91%
United Va Ccn	$32 - $36	91%
Martin'S Point Health	$33 - $37	94%
Ambetter / Centene	$56 - $64	160%
Maine Community Health	$85 - $190	242%
Tufts Health Plan	$156 - $211	445%
Aetna	$162 - $239	462%
Corvel	$196 - $258	559%
Evernorth	$218 - $287	622%
Healthcare Value Mgmt	$229 - $301	653%
First Health	$231 - $305	659%
Oxford Health Plans	$259 - $341	739%

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 $285.
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 Medical Center 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.