CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Alaska Regional Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $283
Cash Discount Price: $479
vs. Medicare Baseline: 8.73x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Alaska Regional Hospital is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $479. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 8.73x the Medicare baseline. Located in 2801 Debarr Road, Anchorage, AK.

Cash / Self-Pay

$479

Average discount available for prompt cash payment at this facility.

Insurance Median

$283

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$32.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.4 (100%)

Cash / Self-Pay: $479 (1478%)

Insurance Median: $283 (873%)

Cash: $479 (1478% of Medicare)

Ins. Median: $283 (873% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.4 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 873% of the Medicare baseline (a markup of 773%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Triwest Healthcare Alliance	$36 - $41	111%
Veteran'S Administration	$36 - $41	111%
United	$37 - $384	114%
Veterans Evaluation Services	$45 - $51	139%
Union Coalition	$133 - $150	410%
Union Coalition Cement Masons	$138 - $156	426%
Moda Health	$143 - $239	441%
Premerafirst	$223 - $252	688%
Geha Ppo Usa	$232 - $445	716%
Cigna	$244 - $276	753%
Multiplan	$270 - $473	833%
Coventry Healthcare	$283 - $320	873%
First Health	$315 - $356	972%
Bering Strait School District	$337 - $381	1040%
Nreca Group Benefit Trust	$337 - $381	1040%
Risk & Benefit Management	$337 - $381	1040%
Banner Health	$360 - $407	1111%
Matanuska Telephone	$360 - $407	1111%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $479.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97535.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Alaska Regional Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97535.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.