CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Harlingen Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $34
  • Cash Discount Price: $34
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Harlingen Medical Center is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 0.97x the Medicare baseline. Located in 5501 South Expressway 77, Harlingen, TX.
Cash / Self-Pay
$34

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $34 (97%)
Insurance Median: $34 (97%)
Cash: $34 (97% of Medicare)
Ins. Median: $34 (97% 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
Aetna $34 97%
Blue Cross Blue Shield $34 - $129 97%
Careworks Worker Compensation Fka Rockport Community Network $34 97%
Cigna $34 - $35 97%
Humana $34 97%
Medicare (plans) $34 97%
San Benito Medical Associates $34 97%
Superior Health Plan $34 97%
Texas Bluebonnett Health Plan $34 - $56 97%
Tricare $34 97%
UnitedHealthcare $34 97%
Veterans Evaluation Services $34 97%
Wellmed $34 97%
Workers Compensation $34 97%
Imperial Insurance Company $36 103%
Molina $36 - $53 103%
Provider Partners Health Plan $36 103%
Asserta Health $44 125%
Friday Health Plan $44 125%
Magic Valley Electric Cooperative $44 125%
Superior Health Commercial Exchange $44 125%
Employer Direct Healthcare $48 137%
Corporate Remedies Worker Compensation $51 145%
Naphcare $53 151%
Baker Benefits Administrators $68 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5501 South Expressway 77, Harlingen, TX 78550
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals