CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Northwest Medical Center Sahuarita

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $52
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Northwest Medical Center Sahuarita is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.60x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $106 (327%)
Insurance Median: $52 (160%)
Cash: $106 (327% of Medicare)
Ins. Median: $52 (160% 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
Aetna $31 - $166 96%
Blue Cross Blue Shield $31 - $138 96%
Cigna $31 - $300 96%
Humana $31 96%
Medicare (plans) $31 96%
Mercy Care $31 - $53 96%
Node Caremore Mcr Adv $31 96%
Node Mercy Care Mcr Adv $31 96%
UnitedHealthcare $31 - $185 96%
Department Of Veterans Affairs $32 99%
Node Champva $32 99%
Node Clover Health Mcr Adv $32 99%
Node Devoted Health Mcr Adv $32 99%
Node Non Par Hospice Agree $32 99%
Node Triwest $32 99%
Node Va $32 99%
Tricare $32 99%
Banner Mcr Adv $33 102%
Node Banner Mcr Adv $33 102%
Node Wellcare Mcr Adv $33 102%
Ambetter / Centene $45 139%
Node Us Dept Of Labor $46 142%
Node Health Choice Health Exchange $47 145%
Medicaid / KanCare $53 - $57 164%
Node Fusion Network $57 176%
Node J Allen Inmate Health Svcs $60 185%
Self Pay $67 - $145 207%
Coventry Work Comp Al $223 688%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals