CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Mobridge Regional Hospital - Cah

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $49
Cash Discount Price: $113
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Mobridge Regional Hospital - Cah is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.40x the Medicare baseline. Located in 1401 10Th Ave West, Mobridge, SD.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $113 (322%)

Insurance Median: $49 (140%)

Cash: $113 (322% of Medicare)

Ins. Median: $49 (140% 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
Medica Mcare Advan	$17 - $49	48%
UnitedHealthcare	$17 - $105	48%
Medica Mn Health Care	$18 - $51	51%
Medica Msho Mcare	$18 - $51	51%
Wellmark Indem/Ppo-All Plans	$35 - $100	100%
Medica Comm-All Other Plans	$38 - $109	108%
Avera/Dakotacare-All Plans	$44 - $124	125%
Sanford Healthplan-All Plans	$44 - $124	125%

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 $113.
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 Mobridge Regional Hospital - Cah 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.