CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: OHSU Hospital and Clinics

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $44
  • Cash Discount Price: $134
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at OHSU Hospital and Clinics is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.25x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.
Cash / Self-Pay
$134

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $134 (382%)
Insurance Median: $44 (125%)
Cash: $134 (382% of Medicare)
Ins. Median: $44 (125% 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
Care Oregon $30 - $44 86%
Intercommunity Health Network $30 86%
Kaiser Foundation Hospitals $30 - $87 86%
Medicare (plans) $30 - $60 86%
Pacific Source $30 - $160 86%
Humana $37 - $40 106%
Trillium $37 106%
Moda $39 - $130 111%
Aetna $40 - $161 114%
Community Health Plan Of Washington $40 - $52 114%
Samaritan Health Plan $40 - $94 114%
UnitedHealthcare $40 - $64 114%
Health Net Health Plan Of Oregon, Inc. $43 - $160 123%
Providence Health Plan $45 - $175 128%
Blue Cross Blue Shield $129 368%
Tuality Health $134 382%
Coventry First Health $154 439%
First Choice $156 445%
Cigna $188 536%
Molina Exchange $206 587%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3181 Sw Sam Jackson Park Road, Portland, OR 97239
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals