Occupational therapy (therapeutic activities)
Facility: Northern Louisiana Medical Center
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $232
- Cash Discount Price: $150
- vs. Medicare Baseline: 6.62x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 662% of the Medicare baseline (a markup of 562%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Medicaid / KanCare | $9 - $273 | 26% |
| Aetna | $9 - $164 | 26% |
| Blue Cross Blue Shield | $9 - $76 | 26% |
| UnitedHealthcare | $9 - $164 | 26% |
| Humana | $10 - $43 | 29% |
| Champus | $27 | 77% |
| Champva | $27 | 77% |
| Tricare | $27 - $33 | 77% |
| Medicare (plans) | $33 | 94% |
| Veterans Evaluation Svcs | $33 | 94% |
| Mutual of Omaha | $33 | 94% |
| VA | $33 | 94% |
| Vantage Advantage | $33 | 94% |
| Gulf South Services | $33 | 94% |
| First Health | $55 - $232 | 157% |
| Vantage Health Plan Ppaca | $64 | 182% |
| Vantage Health Plan | $67 | 191% |
| Golden Rule Ins | $102 - $164 | 291% |
| Verity Healthnet | $134 | 382% |
| Kaiser Permanente | $136 | 388% |
| Cigna | $136 | 388% |
| Self Pay | $150 | 428% |
| Gilsbar | $150 | 428% |
| Geha | $218 - $259 | 622% |
| Multiplan | $232 | 662% |
| PHCS | $232 | 662% |
| Work Comp First Health | $246 | 701% |
| Work Comp Nlmc Emp | $246 | 701% |
| Work Comp City of Ruston | $246 | 701% |
| Workers Compensation | $246 | 701% |
| McR American Hlth Adv | $273 | 778% |
| Hospice of Caring Hearts | $273 | 778% |
| Ima Insurance | $273 | 778% |
| Ltu Athletics | $273 | 778% |
| Liberty Healthshare | $273 | 778% |
| Principal Mutual Life Ins | $273 | 778% |
| United Teachers Ins | $273 | 778% |
| United American | $273 | 778% |
| Bankers Life and Casualty | $273 | 778% |
| American Life Accident | $273 | 778% |
| Crime Victims Compensatio | $273 | 778% |
| Lifecare Specialty Hosp | $273 | 778% |
| Healthfirst Tpa | $273 | 778% |
| Sterling Investors Life | $273 | 778% |
| Apwu Health Plan | $273 | 778% |
| Specialty Hosp of Winnfie | $273 | 778% |
| Nalc Natl Assoc Ltr Carri | $273 | 778% |
| Ruston Regional Specialty | $273 | 778% |
| Union Fidelity Life Ins | $273 | 778% |
| Mva Insurance Payors | $273 | 778% |
| Protective Life Ins | $273 | 778% |
| Nalc Health Benefit Plan | $273 | 778% |
| Gsu Athletics | $273 | 778% |
| Gmp Employers Retiree Tru | $273 | 778% |
| Fox Everett Inc | $273 | 778% |
| Physicians Mutual Ins | $273 | 778% |
| Liberty Mutual Group | $273 | 778% |
| Lincoln Kidney Center | $273 | 778% |
| Aflc American Family Life | $273 | 778% |
| The Hartford | $273 | 778% |
| State Mutual Ins | $273 | 778% |
| Ltu Student Ins Bollinger | $273 | 778% |
| Nlmc Community Services | $273 | 778% |
| Industrial Accounts | $273 | 778% |
| Premier Hospice | $273 | 778% |
| State Farm Insurance | $273 | 778% |
| Misc Commercial | $273 | 778% |
| Union Bankers Insurance C | $273 | 778% |
| Us Dept of Labor | $273 | 778% |
| Benefit Trust Life | $273 | 778% |
| Washington National Ins | $273 | 778% |
| Lin Parish Detention | $273 | 778% |
| Guarantee Trust Life Ins | $273 | 778% |
| Newera | $273 | 778% |
| Equitable | $273 | 778% |
| Aarp | $273 | 778% |