CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Dallas Regional Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $38
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Dallas Regional Medical Center is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.08x the Medicare baseline. Located in 1011 North Galloway Avenue, Mesquite, TX.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $35 (100%)
Insurance Median: $38 (108%)
Cash: $35 (100% of Medicare)
Ins. Median: $38 (108% 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
Careworks Fka (Rockport Community Network) Workercomp $33 94%
Blue Cross Blue Shield $34 - $157 97%
Aetna $35 - $53 100%
Care N Care Insurance Company $35 100%
Cigna $35 - $36 100%
Medicare (plans) $35 100%
Superior Health Plan/Wellcare $35 - $46 100%
Texas Bluebonnett Health Plan $35 - $58 100%
Tricare $35 100%
UnitedHealthcare $35 - $173 100%
Usa Senior Care Network $35 100%
Wellmed $35 100%
Wellpoint Amerigroup $35 100%
Imperial Insurance Companies Mcr $37 106%
Molina $37 106%
Multiplan $37 106%
Provider Partners Health Plan $37 106%
American Health Plan $39 111%
Hi Card $44 125%
Worker Compensation $46 - $70 131%
American Correction Healthcare $48 137%
Employee Direct Healthcare $49 140%
Total Plans Srvices $49 140%
Wellpath $51 145%
Corporate Remedies Workers Comp $53 151%
Naphcare -Prison $54 154%
Elap Services $58 165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1011 North Galloway Avenue, Mesquite, TX 75149
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals