Occupational therapy (therapeutic activities)
Facility: Mount Carmel East & West
Billing Code: 97530 (CPT)
This hospital's typical commercial price is $44 compared to the $39 fair price benchmark.
2-Star CMS clinical quality rating paired with 1.13× fair market pricing.
Highest price of the 9 OH hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.
Note: The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.
A fair price for a Occupational therapy (therapeutic activities) is about $39 (about 1.1× the $35 Medicare rate). Mount Carmel East & West charges insurers about $44, or about $165 in cash — about the fair price. Located in Columbus, OH.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 of 6 major insurers have a published price at this hospital
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 | $33 - $283 | 94% |
| Blue Cross Blue Shieldmajor | $33 - $254 | 94% |
| Aetnamajor | $33 - $254 | 94% |
| Cignamajor | $232 | 662% |
| Humanamajor | $130 - $254 | 371% |
| AmeriHealth | $119 | 339% |
| CareSource | $185 | 528% |
| GEHA | $114 - $283 | 325% |
| HealthLink | $190 | 542% |
| HealthPartners | $232 | 662% |
| MagnaCare | $119 | 339% |
| Medical Mutual | $61 - $193 | 174% |
| MVP Health Care | $232 | 662% |
| Oscar Health | $55 | 157% |
| Priority Health | $232 | 662% |
| Sentara | $254 | 724% |
| UniCare | $119 | 339% |
| + 90 smaller / regional plans | $34 - $632 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Mount Carmel East & West
Compare: Occupational therapy (therapeutic activities) at other OH hospitals
- Institute for Orthopaedic Surgery · Lima $22
- Cincinnati Children's Hospital Medical Center · Cincinnati $23
- University Hospitals Samaritan Medical Center · Ashland $33
- Riverside Methodist Hospital · Columbus $33
- Wilson Memorial Hospital · Sidney $33
- Ohiohealth O'Bleness Hospital · Athens $33
- Grant Medical Center · Columbus $33
- Parma Community General Hospital · Parma $33
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Mount Carmel East & West (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $92
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $92).
Self-Pay Cash Rate ($165) Beats Your Bill
Mount Carmel East & West's published 45 CFR § 180 self-pay cash rate is $165 (vs. $44 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $39 Fair BaseRate ($35 Medicare)
Your bill ($254) is $215 above the denoised Fair BaseRate ($39) and 7.3× the $35 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.