CMS Price Transparency Data
Occupational therapy (therapeutic activities)
Facility: Montefiore St Luke's Cornwall
Billing Code: 97530 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$134
about 3.8× the $35 Medicare rate · typically $43–$193
modeled estimate · not a bill or quote
Medicare pays $35 Fair price $134 Hospital's list price $404
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $473 | 1349% |
| Blue Cross Blue Shieldmajor | $145 - $282 | 413% |
| Aetnamajor | $110 - $129 | 314% |
| Cignamajor | $315 | 898% |
| GEHA | $129 | 368% |
| MagnaCare | $118 | 336% |
| MVP Health Care | $75 - $214 | 214% |
| Oscar Health | $273 | 778% |
| + 5 smaller / regional plans | $4 - $473 |
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
Self-Pay How to get the cash price
Insurance Before you use insurance
Other Procedures at Montefiore St Luke's Cornwall
Compare: Occupational therapy (therapeutic activities) at other NY hospitals
- Highland Hospital · Rochester $13
- Sisters of Charity Hospital · Buffalo $24
- Kenmore Mercy Hospital · Kenmore $24
- Strong Memorial Hospital · Rochester $25
- Cayuga Medical Center at Ithaca · Ithaca $25
- F F Thompson Hospital · Canandaigua $31
- Westfield Memorial Hospital Inc · Westfield $33
- Jones Memorial Hospital · Wellsville $34
Insurance negotiated median for the same procedure, sorted lowest first.