Occupational therapy (therapeutic activities)
Facility: University Medical Center
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $135
- Cash Discount Price: $108
- vs. Medicare Baseline: 3.85x 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 385% of the Medicare baseline (a markup of 285%). 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 |
|---|---|---|
| Cement Masons & Plasters H&W | $23 - $147 | 66% |
| Aig | $23 - $163 | 66% |
| Beech Street | $23 - $163 | 66% |
| Surest | $29 - $323 | 83% |
| American Postal Workers Health Plan | $29 - $323 | 83% |
| UnitedHealthcare | $29 - $323 | 83% |
| Switch | $29 - $147 | 83% |
| Las Vegas Firefighters 1285 | $29 - $147 | 83% |
| Cirque De Soleil | $31 - $87 | 88% |
| Great West Healthcare | $31 - $87 | 88% |
| Cigna | $31 - $87 | 88% |
| Kaiser | $31 - $87 | 88% |
| Blue Cross Blue Shield | $31 - $87 | 88% |
| City of North Las Vegas | $31 - $147 | 88% |
| Sierra Health and Life | $31 - $208 | 88% |
| National Security Technologies | $31 - $87 | 88% |
| Molina | $31 - $191 | 88% |
| Ambetter / Centene | $31 - $191 | 88% |
| Sheet Metal Workers | $42 - $87 | 120% |
| Caesar's Entertainment | $42 - $147 | 120% |
| Ufcw Local 711 Retail Clerks | $42 - $147 | 120% |
| California Ironwork Field Welfare | $42 - $87 | 120% |
| So Ca Pipe Trades H&W | $42 - $87 | 120% |
| Boyd Group | $42 - $147 | 120% |
| Laborers Health and Welfare | $42 - $147 | 120% |
| Teamsters Local 986 | $42 - $147 | 120% |
| Electrical Workers | $42 - $147 | 120% |
| Teamsters Local 14 | $42 - $147 | 120% |
| Southwest Carpenters H&W | $42 - $87 | 120% |
| Bricklayers Local 13 | $42 - $147 | 120% |
| Teamsters Local 631 | $42 - $147 | 120% |
| Plumbers & Pipefitters Loc 525 | $42 - $147 | 120% |
| Operating Engineers | $42 - $147 | 120% |
| Aetna | $57 - $156 | 163% |
| Mail Handlers Benefit Plan | $62 | 177% |
| Nevada Energy | $62 | 177% |
| Coventry | $62 | 177% |
| First Health | $72 | 205% |
| Three Rivers Provider Network | $72 | 205% |
| Health Net | $72 - $295 | 205% |
| Advantra Freedom | $87 | 248% |
| Scan | $104 | 297% |
| Clark County Detention Center | $104 | 297% |
| Alignment Health | $104 | 297% |
| Laughlin Coalition | $135 | 385% |
| Culinary Workers Hwf | $147 | 419% |
| Mgm Grand | $147 | 419% |
| Resorts World Las Vegas | $147 | 419% |
| City of Henderson | $147 | 419% |
| Mirage Las Vegas | $147 | 419% |
| Nevada Hand | $147 | 419% |
| Las Vegas Metro Police Dept | $147 | 419% |
| Clark County EPO | $147 | 419% |
| Clark County Self Funded | $147 | 419% |
| Employee Painters Trust | $147 | 419% |
| Clark County Firefighters 1908 | $147 | 419% |
| Wynn Resorts | $147 | 419% |
| Truline Corporation | $153 | 436% |
| Golden Entertainment | $153 | 436% |
| Stations Casinos | $153 | 436% |
| Pli Las Vegas | $153 | 436% |
| P3 Health Partners | $153 | 436% |
| Marshall Retail Group | $153 | 436% |
| Golden Nugget Hotel & Casino | $153 | 436% |
| Teacher's Health Trust | $153 | 436% |
| Rebel Oil Company | $153 | 436% |
| Arroweye Solutions | $153 | 436% |
| Venetian/Palazzo | $153 | 436% |
| State of Nevada | $153 | 436% |
| Dignity Health | $153 | 436% |
| Selecthealth | $191 | 545% |
| Health Direct Partners | $191 | 545% |
| Zuffa | $208 | 593% |
| Prominence Health Plan | $208 | 593% |
| Jw Marriott | $208 | 593% |
| Nevada Preferred Professionals | $208 | 593% |
| Universal Health Network (Uhn) | $208 | 593% |
| One Health Plan | $243 | 693% |
| Hometown Health Plan of Nevada | $243 | 693% |
| VA Pc3 (VA Choice) | $312 | 890% |
| Las Vegas Sand Corps | $323 | 921% |