CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 97530 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$131
about 3.7× the $35 Medicare rate · typically $39–$203
modeled estimate · not a bill or quote
What this hospital charges insurers
$146
About the fair price
about $15 over the fair price · 4.2× Medicare
Medicare pays $35 Fair price $131 This hospital $146 Cash price $119 Hospital's list price $205

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $30 Priciest $146

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Occupational therapy (therapeutic activities) is about $131 (about 3.7× the $35 Medicare rate). Gundersen St Josephs Hospital and Clinics charges insurers about $146, or about $119 in cash — about the fair price. Located in Hillsboro, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $109 - $143 311%
Blue Cross Blue Shieldmajor $94 - $352 268%
Aetnamajor $195 556%
Cignamajor $168 479%
Humanamajor $174 496%
Amerigroup $15 43%
Quartz $112 319%
Security Health Plan $40 114%
UCare $107 - $164 305%
+ 4 smaller / regional plans $94 - $194
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 400 Water Ave, Hillsboro, WI 54634
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals