CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Medical Center of McKinney

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $51
  • Cash Discount Price: $152
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Medical Center of McKinney is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.45x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
$152

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $152 (433%)
Insurance Median: $51 (145%)
Cash: $152 (433% of Medicare)
Ins. Median: $51 (145% 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.

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
Superior Health Plan $8 - $36 23%
Cigna $15 - $127 43%
United $21 - $34 60%
Oscar $23 - $33 66%
Blue Cross Blue Shield $29 - $218 83%
Unicare $29 - $158 83%
Aetna $30 - $179 86%
Amerigroup $30 - $34 86%
Care N Care $30 - $34 86%
Devoted Health $30 - $34 86%
Humana $30 - $284 86%
Mutual Of Omaha $30 - $34 86%
Triwest Veterans $30 - $34 86%
Wellmed $30 - $34 86%
American Health Plan Of Texas, Inc. $31 - $36 88%
Integranet $31 - $35 88%
Procare Advantge $31 - $36 88%
Wellcare $31 - $35 88%
Provider Partners Health Plan $32 - $36 91%
Texas Independent Health Plan $32 - $36 91%
Cenpatico $33 - $37 94%
Imperial Insurance Company $33 - $37 94%
Molina $33 - $37 94%
Universal Healthcare Group $36 - $41 103%
Healthcare Highways $38 - $54 108%
City Of Mckinney $39 - $55 111%
Verda Health Plan $39 - $44 111%
Evry Health $40 - $41 114%
Bravo Health $45 - $51 128%
Fidelis Securecare $50 - $71 143%
Superior $54 - $76 154%
National Choicecare $56 - $79 160%
Usa Managed Care $57 - $127 163%
Corvel Corporation $59 - $67 168%
Pc Texas Partners $61 - $87 174%
Physicians Coop Of Tx $61 - $87 174%
Rockport Health Group $61 - $87 174%
Curative Administrators $62 - $63 177%
Averde Health, Inc $65 - $92 185%
Magellan Bh $67 - $95 191%
Value Options Behavioral Health $67 - $95 191%
Coastal Comp Health Networks $78 - $111 222%
Mega Life $78 - $111 222%
Molina Healthcare $78 - $89 222%
Multiplan Phcs $78 - $111 222%
Lewisville Isd/Dls Consulting $84 - $119 240%
Compsych Corporation $89 - $127 254%
Healthsmart Preferred Care $89 - $127 254%
Galaxy Health Network $95 - $135 271%
Independent Medical Systems $111 - $158 317%
National Healthcare Solutions $111 - $158 317%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals