CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Baptist Memorial Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $121
Cash Discount Price: $47
vs. Medicare Baseline: 3.45x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Baptist Memorial Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 3.45x the Medicare baseline. Located in 6019 Walnut Grove Road, Memphis, TN.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $47 (134%)

Insurance Median: $121 (345%)

Cash: $47 (134% of Medicare)

Ins. Median: $121 (345% 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 345% of the Medicare baseline (a markup of 245%). 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
Blue Cross Blue Shield	$22 - $150	63%
Aetna	$24 - $65	68%
Magnolia Tn	$40 - $50	114%
Humana	$72	205%
Ppo Holdings	$77 - $95	220%
Cooper Realty	$81 - $100	231%
Magnolia Regional Health Center	$81 - $100	231%
Multiplan	$87 - $188	248%
Littler	$101 - $125	288%
Molina	$101 - $125	288%
Ppo Plus	$101 - $200	288%
Mpcn	$105 - $130	299%
First Choice Health Plan Of Ms	$107 - $132	305%
Novasys	$117 - $145	334%
Access Health Services	$121 - $150	345%
Butler Snow	$121 - $150	345%
UnitedHealthcare	$121 - $150	345%
Oscar	$130	371%
Qca	$152 - $188	433%
Christian Health Aid	$162 - $200	462%
St. Jude Children'S Hospital	$182 - $225	519%

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 $47.
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 Baptist Memorial 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.