CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Sky Lakes Medical Center

Billing Code: 97530 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$38

about 1.1× the $35 Medicare rate · typically $34–$40

modeled estimate · not a bill or quote

What this hospital charges insurers

$34

Below the fair price — a good deal

about $4 under the fair price · 1.0× Medicare

Medicare pays $35 Fair price $38 This hospital $34 Cash price $98 Hospital's list price $130

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

One of the lower prices — 7 of 8 other OR hospitals charge more for the same procedure.

Cheapest $30 Priciest $38

Black dot = this hospital, among the 9 OR hospitals with a price for this procedure. Full list below.

A fair price for a Occupational therapy (therapeutic activities) is about $38 (about 1.1× the $35 Medicare rate). Sky Lakes Medical Center charges insurers about $34, or about $98 in cash — below the fair price — a good deal. Located in Klamath Falls, OR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser 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	$34 - $130	97%
Blue Cross Blue Shieldmajor	$34 - $130	97%
Aetnamajor	$34 - $130	97%
Cignamajor	$34 - $130	97%
Humanamajor	$34 - $130	97%
Kaiser Permanentemajor	$34 - $130	97%
GEHA	$130	371%
Health Net	$130	371%
HealthPartners	$130	371%
Moda Health	$107 - $150	305%
MVP Health Care	$130	371%
PacificSource	$34 - $117	97%
Providence Health Plan	$130 - $169	371%
Sanford Health Plan	$130	371%
UPMC Health Plan	$130	371%
WellCare	$34	97%
+ 201 smaller / regional plans	$34 - $130

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 19 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 98), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 97530.

Insurance Before you use insurance

Call your insurance company to confirm Sky Lakes Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 97530.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sky Lakes Medical Center

Compare: Occupational therapy (therapeutic activities) at other OR hospitals

Insurance negotiated median for the same procedure, sorted lowest first.