CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: University Medical Center of El Paso

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $57
Cash Discount Price: $27
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at University Medical Center of El Paso is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.63x the Medicare baseline. Located in 4815 Alameda Ave, El Paso, TX.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $27 (77%)

Insurance Median: $57 (163%)

Cash: $27 (77% of Medicare)

Ins. Median: $57 (163% 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
Aetna	$21 - $88	60%
Cigna	$25 - $118	71%
El Paso Health Dual	$27 - $35	77%
Amerigroup Tx	$34	97%
Healthnet	$34	97%
Medicaid / KanCare	$34	97%
Molina Tx	$34	97%
Superior Tx	$34	97%
Molina	$35	100%
Wellmed	$55 - $70	157%
El Paso Health	$60 - $77	171%
Humana	$69 - $88	197%
UnitedHealthcare	$87	248%
Blue Cross Blue Shield	$93 - $121	265%

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 $27.
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 University Medical Center of El Paso 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.