Occupational therapy evaluation, low complexity, 30 minutes at Mercy Health Saint Marys

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Ot Evaluation Low Complexity Patient/Family

Grand Rapids, MI

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How this price compares nationally

Mercy Health Saint Marys’s median price of $181 is 16% above the median hospital's median price ($155), higher than 59% of the 2,514 hospitals reporting CPT 97165. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 97165 at Mercy Health Saint Marys

Negotiated rates from the hospital’s own file: 22 payers, 31 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Blue Cross Blue Shield blue cross complete medicaid facility · fee schedule · both	$52.93	$52.93	$52.93 – $52.93
2	Molina molina medicaid facility · fee schedule · both	$53.97	$53.97	$53.97 – $53.97
3	Aetna aetna medicare advantage facility · fee schedule · both	$94.88	$94.88	$94.88 – $94.88
4	Blue Cross Blue Shield bcbs medicare advantage facility · fee schedule · both	$94.88	$94.88	$94.88 – $94.88
5	Molina molina medicare advantage facility · fee schedule · both	$94.88	$94.88	$94.88 – $94.88
6	UnitedHealthcare united healthcare medicare advantage facility · fee schedule · both	$99.72	$99.72	$99.72 – $99.72
7	Oscar oscar epo facility · fee schedule · both	$123.93	$123.93	$123.93 – $123.93
8	Molina molina hmo marketplace facility · fee schedule · both	$125.87	$125.87	$125.87 – $125.87
9	Aetna aetna preferred facility · percent of total billed charges · bothfrom % of charges	$138.79	$138.79	$138.79 – $138.79
10	Anthem bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
11	Blue Cross Blue Shield bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
12	Carefirst bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
13	Excellus bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
14	Highmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
15	Kaiser bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
16	Premera bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
17	Regence bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
18	Wellmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$151.85	$151.85	$151.85 – $151.85
19	Aetna aetna ppo facility · percent of total billed charges · bothfrom % of charges	$197.19	$197.19	$197.19 – $197.19
20	Medical Mutual aetna ppo facility · percent of total billed charges · bothfrom % of charges	$197.19	$197.19	$197.19 – $197.19
21	Caresource hap hmo facility · percent of total billed charges · bothfrom % of charges	$205.14	$205.14	$205.14 – $205.14
22	Cigna priority health cigna ppo facility · percent of total billed charges · bothfrom % of charges	$229.09	$229.09	$229.09 – $229.09
23	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$229.22	$229.22	$229.22 – $229.22
24	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$229.22	$229.22	$229.22 – $229.22
25	UnitedHealthcare united healthcare ppo facility · percent of total billed charges · bothfrom % of charges	$238.64	$238.64	$238.64 – $238.64

Page 1 of 2 · 31 rates

Last updated: Mar 31, 2026

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