CMS Price Transparency Data
Occupational therapy (self-care training)
Facility: Mercy Hospital Northwest Arkansas
Billing Code: 97535 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97535
- Insurance Median: $44
- Cash Discount Price: $97
- vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Mercy Hospital Northwest Arkansas is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.36x the Medicare baseline. Located in 2710 South Rife Medical Lane, Rogers, AR.
Cash / Self-Pay
$97
Average discount available for prompt cash payment at this facility.
Insurance Median
$44
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: $97 (299%)
Insurance Median: $44 (136%)
Cash: $97 (299% of Medicare)
Ins. Median: $44 (136% 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 |
|---|---|---|
| Mercy Interfacility [20513] | $27 | 83% |
| Medicaid / KanCare | $28 - $41 | 86% |
| Aetna | $29 - $112 | 90% |
| American Health Advantage Of Mo Mcr [20264] | $29 | 90% |
| Blue Cross Blue Shield | $29 - $38 | 90% |
| Cherokee Nation Health Serv Contracted [320066] | $29 | 90% |
| Cigna | $29 - $164 | 90% |
| Cross Timbers Hospice [20098] | $29 | 90% |
| Dept Of Veteran Affairs Contracted [320106] | $29 | 90% |
| Elara Caring Aspire Hospice Contracted [320433] | $29 | 90% |
| Elara Caring Aspire Hospice [20433] | $29 | 90% |
| Globalhealth Contracted [320145] | $29 | 90% |
| Halo Hcr Inc Hospice Contracted [320432] | $29 | 90% |
| Halo Hcr Inc Hospice [20432] | $29 | 90% |
| Humana | $29 - $119 | 90% |
| Independent Health [20197] | $29 | 90% |
| Jordan Valley Senior Care Pace [20515] | $29 | 90% |
| Kindful Hospice Contracted [320434] | $29 | 90% |
| Kindful Hospice [20434] | $29 | 90% |
| Medical Associates Health [20444] | $29 | 90% |
| Medicare (plans) | $29 - $30 | 90% |
| Mercy Hospice Okc [20252] | $29 | 90% |
| Pace Of The Ozarks [20518] | $29 | 90% |
| Provider Partners Health Plans Contracted [320450] | $29 | 90% |
| Qual Choice Contracted [320325] | $29 | 90% |
| Spina Bifida Hlthcare Benefit [20506] | $29 | 90% |
| Tribute Health Plan Mcr [20338] | $29 | 90% |
| UnitedHealthcare | $29 - $157 | 90% |
| Valir Pace [20503] | $29 | 90% |
| Wellfirst Health Mcr [20443] | $29 | 90% |
| St Johns Mercy Rehab Llc Contracted [320359] | $32 | 99% |
| St Johns Mercy Rehab Llc [20359] | $32 | 99% |
| Tricare | $32 | 99% |
| Usable Contracted [320409] | $38 | 117% |
| Ambetter / Centene | $41 | 127% |
| Home State Health Plan Contracted [320187] | $41 | 127% |
| Novasys Contracted [320285] | $41 - $141 | 127% |
| Health Choice Contracted [320166] | $46 | 142% |
| Aither Health Contracted [320449] | $60 | 185% |
| Edison Health Solutions Contracted [320502] | $60 | 185% |
| Mercy Benefit Admin Contracted [320251] | $60 - $89 | 185% |
| Yuzu Health Contracted [320521] | $60 | 185% |
| 90 Degree Benefits Contracted [320436] | $74 | 228% |
| Show-Me Health Administrators Contracted [320483] | $74 | 228% |
| Auxiant Contracted [320462] | $89 - $97 | 275% |
| Ebms Contracted [320493] | $89 | 275% |
| Healthlink Contracted [320179] | $89 - $97 | 275% |
| Imagine 360 Contracted [320494] | $89 | 275% |
| Municipal Health Plan Contracted [320271] | $89 | 275% |
| Reflect Health Contracted [320492] | $89 | 275% |
| Benefit Management Contracted [320052] | $97 | 299% |
| Federal Medical Center Contracted [320127] | $97 | 299% |
| Insurance System Inc Contracted [320465] | $97 | 299% |
| Personify Health Contracted [320051] | $97 | 299% |
| Point C Contracted [320238] | $97 | 299% |
| Preferred Health Plan Contracted [320522] | $97 | 299% |
| Tri State Healthcare Coalition Contracted [320379] | $97 | 299% |
| Workers Comp [20426] | $97 | 299% |
| Qual Choice Contracted [320324] | $104 | 321% |
| Private Health Care Systems Contracted [320320] | $109 | 336% |
| Private Health Care Systems [20320] | $109 | 336% |
| Ppo Plus Contracted [320310] | $112 | 346% |
| First Health Contracted [320128] | $115 | 355% |
| Employers Health Coalition Contracted [320116] | $117 | 361% |
| Healthscope Contracted [320182] | $119 | 367% |
| Multiplan Contracted [320270] | $127 | 392% |
| Multiplan [20270] | $127 | 392% |
| United Medical Resources Contracted [320454] | $157 | 485% |