CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $58
Cash Discount Price: $151
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Crystal Clinic Orthopaedic Center is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.65x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $151 (431%)

Insurance Median: $58 (165%)

Cash: $151 (431% of Medicare)

Ins. Median: $58 (165% 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.

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
Aultcare - All Plans	$23 - $111	66%
Bc Blue Access	$27 - $664	77%
Bc Ohi/Ohii	$27 - $597	77%
Bc Pathway	$27 - $435	77%
Bc Preferred	$27 - $664	77%
Bc Trad - All Other Plans	$27 - $664	77%
Bc Mcr Adv	$33	94%
Health Oh Network - All Plans	$33 - $209	94%
Ohio Health Choice - All Plans	$33 - $209	94%
Summacare Mcr Adv	$33	94%
UnitedHealthcare	$33 - $732	94%
Multiplan - All Plans	$36 - $230	103%
Summacare Comm - All Other Plans	$36 - $644	103%
The Health Plan - All Plans	$43 - $67	123%
Cigna	$45 - $125	128%
Healthsmart - All Plans	$47 - $296	134%
Med Mutual Nas	$50 - $217	143%
Med Mutual Medflex	$651	1856%
Med Mutual Aca	$741	2113%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$814	2321%
Aetna	$825	2352%

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 $151.
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 Crystal Clinic Orthopaedic 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.