CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Baptist Memorial Hospital-Crittenden, Inc

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $112
Cash Discount Price: $32
vs. Medicare Baseline: 3.46x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Baptist Memorial Hospital-Crittenden, Inc is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 3.46x the Medicare baseline. Located in 2100 North Seventh Street, West Memphis, AR.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $32 (99%)

Insurance Median: $112 (346%)

Cash: $32 (99% of Medicare)

Ins. Median: $112 (346% 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 346% of the Medicare baseline (a markup of 246%). 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
Aetna	$29 - $67	90%
Novasys	$31 - $35	96%
Blue Cross Blue Shield	$34 - $134	105%
Magnolia Tn	$47 - $53	145%
Humana	$63	194%
Ppo Holdings	$76 - $85	235%
Cooper Realty	$80 - $90	247%
Magnolia Regional Health Center	$80 - $90	247%
Multiplan	$86 - $168	265%
Littler	$100 - $112	309%
First Choice Health Plan Of Ms	$105 - $119	324%
Access Health Services	$119 - $134	367%
Butler Snow	$119 - $134	367%
Primewell	$119 - $134	367%
Oscar	$130	401%
Ppo Plus	$159 - $179	491%

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 $32.
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 Baptist Memorial Hospital-Crittenden, Inc 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.