Occupational therapy (therapeutic activities)
Facility: Medical City Plano
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $36
- Cash Discount Price: $170
- vs. Medicare Baseline: 1.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $12 - $36 | 34% |
| Cigna | $23 - $35 | 66% |
| Blue Cross Blue Shield | $29 - $218 | 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% |
| United | $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% |
| Imperial Insurance Company | $33 - $37 | 94% |
| Molina | $33 - $37 | 94% |
| Triwest Health Alliance | $33 | 94% |
| Oscar | $35 | 100% |
| Universal Healthcare Group | $36 - $41 | 103% |
| Verda Health Plan | $39 - $44 | 111% |
| Bravo Health | $45 - $51 | 128% |
| Lifecare Hospitals | $51 | 145% |
| Superior | $54 - $76 | 154% |
| Healthcare Highways | $57 | 163% |
| Usa Managed Care | $57 - $136 | 163% |
| Corvel Corporation | $59 - $67 | 168% |
| Prominence Health Plan | $68 | 194% |
| City Of Mckinney | $76 | 217% |
| Fidelis Securecare | $76 | 217% |
| Molina Healthcare | $78 - $89 | 222% |
| National Choicecare | $85 | 242% |
| Pc Texas Partners | $93 | 265% |
| Physicians Coop Of Tx | $93 | 265% |
| Rockport Health Group | $93 | 265% |
| Averde Health, Inc | $98 | 279% |
| Texas Healthcare Foundation Wc | $110 | 314% |
| Coastal Comp Health Networks | $119 | 339% |
| Mega Life | $119 | 339% |
| Multiplan Phcs | $119 | 339% |
| Healthsmart Preferred Care | $127 | 362% |
| Lewisville Isd/Dls Consulting | $127 | 362% |
| Usc Health Services | $136 | 388% |
| Galaxy Health Network | $144 | 411% |
| Independent Medical Systems | $170 | 485% |
| National Healthcare Solutions | $170 | 485% |
| Unicare | $170 | 485% |