Occupational therapy (self-care training)
Facility: Adventist Health Hanford
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $47
- Cash Discount Price: $29
- vs. Medicare Baseline: 1.45x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bc Mcal | $5 - $7 | 15% |
| Healthnet Mcal | $5 - $10 | 15% |
| Kaiser Mcal | $5 - $8 | 15% |
| Medi-Cal | $5 - $8 | 15% |
| Universal Hc Mcal Profee | $5 | 15% |
| Valley Childrens - All Plans | $9 - $13 | 28% |
| Fresno - All Plans | $13 | 40% |
| Upn Mcal Profee | $21 | 65% |
| Aetna | $25 - $402 | 77% |
| Blue Shield Mcr Adv | $34 | 105% |
| Fhcn Pace Mcr Adv-All Plans | $34 | 105% |
| Healthnet Mcr Adv | $34 | 105% |
| Kaiser Mcr Adv | $34 - $46 | 105% |
| Prime Health Mcr Adv- All Plans | $34 | 105% |
| Tricare | $34 | 105% |
| UnitedHealthcare | $34 - $292 | 105% |
| Universal Hc Mcr Adv Profee - All Other Plans | $34 | 105% |
| Upn Mcr Adv Profee - All Other Plans | $34 | 105% |
| Central Valley Med Prov Profee Only-All Plans | $36 | 111% |
| Cigna | $37 - $132 | 114% |
| Ah Employee Health Plan - All Plans | $38 - $61 | 117% |
| Blue Shield Epn | $45 - $347 | 139% |
| Kaiser - All Other Plans | $46 - $111 | 142% |
| Western Growers/Pinnacle- All Plans | $47 - $104 | 145% |
| Blue Shield Non-Epn - All Other Plans | $48 - $409 | 148% |
| Blue Cross Blue Shield | $50 - $492 | 154% |
| Healthnet - All Other Plans | $50 - $119 | 154% |
| Bright Health Mcr Adv-All Plans | $54 | 167% |
| Key Medical Group Commercial - All Other Plans | $75 | 231% |
| Key Medical Mcr Adv | $75 | 231% |
| Phcs Ppo- All Plans | $144 | 444% |
| Community Hlth Ntwork-All Plans | $149 | 460% |
| Interplan- All Plans | $150 | 463% |
| First Health - All Plans | $173 | 534% |
| Choicecare- All Plans | $182 | 562% |
| Multiplan- All Plans | $184 | 568% |
| Beech Street- All Plans | $189 | 583% |
| Preferred Health Network- All Plans | $211 | 651% |
| Pacific Health Alliance- All Plans | $215 | 664% |