CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Uva Health Haymarket Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $100
Cash Discount Price: $86
vs. Medicare Baseline: 2.85x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Uva Health Haymarket Medical Center is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 2.85x the Medicare baseline. Located in 15225 Healthcote Boulevard, Haymarket, VA.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $86 (245%)

Insurance Median: $100 (285%)

Cash: $86 (245% of Medicare)

Ins. Median: $100 (285% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 285% of the Medicare baseline (a markup of 185%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Ridge Pace [10510]	$31	88%
Medicaid / KanCare	$31	88%
Veterans [99909]	$33	94%
Aetna	$35 - $204	100%
Blue Cross Blue Shield	$35	100%
Cigna	$35 - $360	100%
HMO Part B [10099]	$35	100%
Humana	$35	100%
Medicare (plans)	$35	100%
UnitedHealthcare	$35 - $282	100%
VA Ccn [99926]	$35	100%
VA Ccn [99927]	$35	100%
Veterans Administration [99910]	$35	100%
Champva [50002]	$37 - $38	106%
Tricare	$37 - $38	106%
Carefirst [30007]	$64 - $68	182%
Sentara [40021]	$82 - $188	234%
Sentara Behavioral Health [40052]	$83 - $188	237%
Multiplan Generic [40035]	$98 - $182	279%
Vhn Generic [40040]	$98 - $182	279%
Beacon Health Options [40012]	$107	305%
Commercial Contracted Hb Only [40056]	$112	319%
Commercial Generic [40000]	$112 - $150	319%
Kaiser Permenente [40014]	$116 - $193	331%
Geha [40009]	$124 - $228	354%
Commercial Contracted Tpa [40055]	$128 - $150	365%
Umwa [40037]	$150	428%
Healthsmart [40013]	$160	456%
First Health Generic [40033]	$175	499%
Gateway Health Alliance [40034]	$182	519%
Onenet Workers Comp Generic [60010]	$187	533%

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 $86.
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 Uva Health Haymarket Medical Center 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.