CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Mercy Hospital Kingfisher, Inc

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $70
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 2.00x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Mercy Hospital Kingfisher, Inc is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 2.00x the Medicare baseline. Located in 1000 Hospital Drive, Kingfisher, OK.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $87 (248%)
Insurance Median: $70 (200%)
Cash: $87 (248% of Medicare)
Ins. Median: $70 (200% 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
Aetna $32 - $92 91%
Humana $32 - $57 91%
Medicaid / KanCare $32 - $40 91%
Ambetter / Centene $40 114%
Home State Health Plan Contracted [320187] $40 114%
Novasys Contracted [320285] $40 114%
Health Choice Contracted [320166] $54 154%
Webtpa Contracted [320417] $56 160%
Blue Cross Blue Shield $57 - $71 163%
Cherokee Nation Health Serv Contracted [320066] $57 163%
Cross Timbers Hospice [20098] $57 163%
Dept Of Veteran Affairs Contracted [320106] $57 163%
Elara Caring Aspire Hospice Contracted [320433] $57 163%
Elara Caring Aspire Hospice [20433] $57 163%
Halo Hcr Inc Hospice Contracted [320432] $57 163%
Halo Hcr Inc Hospice [20432] $57 163%
Independent Health [20197] $57 163%
Indian Health Service Contracted [320198] $57 163%
Kindful Hospice Contracted [320434] $57 163%
Kindful Hospice [20434] $57 163%
Medical Associates Health [20444] $57 163%
Medicare (plans) $57 - $95 163%
Mercy Hospice Okc [20252] $57 163%
Provider Partners Health Plans Contracted [320450] $57 163%
Qual Choice Contracted [320325] $57 163%
Tricare $57 163%
UnitedHealthcare $57 - $94 163%
Cigna $58 - $91 165%
Globalhealth Contracted [320145] $58 165%
Aither Health Contracted [320449] $80 - $114 228%
Mercy Benefit Admin Contracted [320251] $80 - $114 228%
Quik Trip Contracted [320447] $80 228%
Show-Me Health Administrators Contracted [320483] $80 228%
Benefit Management Contracted [320052] $87 - $100 248%
Osma Health Contracted [320292] $94 268%
United Medical Resources Contracted [320454] $94 268%
Medica Contracted [320239] $95 271%
Healthcare Highways Plus Contracted [320175] $100 285%
First Health Contracted [320128] $105 299%
Auxiant Contracted [320462] $114 325%
Ebms Contracted [320493] $114 325%
Healthlink Contracted [320179] $114 325%
Imagine 360 Contracted [320494] $114 325%
Reflect Health Contracted [320492] $114 325%
Yuzu Health Contracted [320521] $114 325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Hospital Drive, Kingfisher, OK 73750
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals