CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Curry General Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $154
Cash Discount Price: $162
vs. Medicare Baseline: 4.39x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Curry General Hospital is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 4.39x the Medicare baseline. Located in 94220 Fourth Street, Gold Beach, OR.

Cash / Self-Pay

$162

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $162 (462%)

Insurance Median: $154 (439%)

Cash: $162 (462% of Medicare)

Ins. Median: $154 (439% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 439% of the Medicare baseline (a markup of 339%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Partnership Health Plan Of Calif Mdcd Hmo [2008]	$19	54%
Tricare	$50	143%
Covid19 Hrsa Uninsured Testing And Treatment Fund [2271]	$70	200%
Medicare (plans)	$70 - $105	200%
Blue Cross Blue Shield	$83 - $162	237%
Medicaid / KanCare	$102 - $105	291%
Department Of Corrections [1051]	$105	299%
First Choice Health Admin [1294]	$105	299%
First Choice [528]	$105	299%
Coordinated Care Commercial [1649]	$138	393%
Pacificsource [1148]	$138	393%
Moda [512]	$139 - $146	396%
Multiplan [1131]	$147	419%
Asuris [1258]	$154	439%
Operating Engineers [1144]	$154	439%
Regence [1351]	$154 - $162	439%
Cigna	$159 - $162	453%
Coventry First Health Managed Care [1774]	$159	453%
Coventry Health [1046]	$159	453%
Providence Health Plan Plm Alt [1692]	$159	453%
Providence Health Plan [567]	$159	453%
Aetna	$162	462%
Employee Bene Admin Mgmt [525]	$162	462%
Geha [531]	$162	462%
Mailhandlers Benefit Pln [547]	$162	462%
Meritain [550]	$162	462%
Nw Sheet Metal Workers [597]	$162	462%
Trustmark [524]	$162	462%
UnitedHealthcare	$162	462%
Zenith Administrators [586]	$162	462%
Allcare Alt [2598]	$300	855%
Allcare [1695]	$300	855%

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 $162.
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 Curry General Hospital 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.