Occupational therapy (therapeutic activities)
Facility: Gadsden Regional Medical Center
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $55
- Cash Discount Price: $66
- vs. Medicare Baseline: 1.57x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $30 | 86% |
| Southern Care Hospice | $32 | 91% |
| Gadsden Hospice | $32 | 91% |
| Humana | $32 | 91% |
| UnitedHealthcare | $32 - $200 | 91% |
| Node Select Health McR Adv | $32 | 91% |
| Veterans Eval Services | $32 | 91% |
| Blue Cross Blue Shield | $32 | 91% |
| Amedisys Hospice | $32 | 91% |
| Node Champva | $32 | 91% |
| Node Viva McR Adv | $32 | 91% |
| Node VA | $32 | 91% |
| Node Non Par Hospice Agree | $32 | 91% |
| Medicare (plans) | $32 | 91% |
| Node Devoted Health McR Adv | $33 | 94% |
| Aetna | $33 - $229 | 94% |
| Cigna | $33 - $172 | 94% |
| Node Wellcare McR Adv | $33 | 94% |
| Node Clover Health McR Adv | $33 | 94% |
| Prime Health | $34 - $319 | 97% |
| Node Eon McR Adv | $34 | 97% |
| Ambetter / Centene | $49 | 140% |
| Node Us Dept of Labor | $52 | 148% |
| Self Pay | $53 - $80 | 151% |
| Alamed Wc | $55 | 157% |
| American Employee Alliance | $177 | 505% |
| Multiplan | $247 - $278 | 704% |
| Viva Healthcare | $265 | 756% |
| Magellan Behavioral | $265 | 756% |
| First Health | $309 - $357 | 881% |
| Beech Street | $323 - $1,525 | 921% |
| Focus Health | $338 | 964% |
| Coventry Work Comp Al | $346 | 987% |
| Work Comp | $376 | 1072% |