CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Island Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $35
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Island Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.00x the Medicare baseline. Located in 1211 24Th Street, Anacortes, WA.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $92 (262%)
Insurance Median: $35 (100%)
Cash: $92 (262% of Medicare)
Ins. Median: $35 (100% 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
Molina Mcaid - All Plans $26 - $32 74%
Amerigroup Mcaid - All Plans $27 - $34 77%
Coordinated Care Mcaid - All Plans $30 - $37 86%
Chpw Mcaid - All Plans $31 - $35 88%
Aarp Mcr Adv - All Plans $33 94%
Humana $33 - $78 94%
Kaiser Mcr Adv $33 94%
Samish Indian Health - All Plans $33 94%
Swinomish Indian Health - All Plans $33 94%
Tricare $33 94%
UnitedHealthcare $33 - $78 94%
Aetna $35 - $87 100%
Premera Mcr Adv $35 100%
Regence Mcr Adv $35 100%
Premera Comm - All Other Plans $61 174%
Regence Comm - All Other Plans $69 197%
Cigna $74 211%
First Choice - All Plans $78 222%
First Health - All Plans $78 222%
Multiplan - All Plans $78 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1211 24Th Street, Anacortes, WA 98221
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals