Occupational therapy (self-care training)
Facility: Ventura County Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $47
- Cash Discount Price: $147
- 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 |
|---|---|---|
| Hpn Ip/Op Only Medi-Cal | $8 | 25% |
| Kaiser Mcal Pediatric Ip/Op Only | $8 | 25% |
| Kaiser Medi-Cal Ip/Op Only | $8 | 25% |
| Medi-Cal | $8 | 25% |
| Americas Hp Mcal Ip/Op Only | $10 | 31% |
| Clinicas Mcal | $10 | 31% |
| Gold Coast Medi-Cal-All Plans | $13 | 40% |
| Tricare | $35 | 108% |
| Alignment Hp - All Plans | $36 | 111% |
| Blue Shield Mcr Adv | $36 | 111% |
| Humana | $36 | 111% |
| UnitedHealthcare | $37 - $160 | 114% |
| Healthnet Mcr Adv | $38 | 117% |
| Americas Hp Mcr Adv Ip/Op Only | $41 | 127% |
| Clinicas Mcr Adv | $41 | 127% |
| Scan-All Plans | $43 | 133% |
| Western Growers-All Plans | $45 | 139% |
| Clinicas Comm - All Other Plans | $47 | 145% |
| Imperial-All Plans | $47 | 145% |
| Ntwrk Provdrs-All Plans | $47 | 145% |
| Americas Hp Comm Ip/Op Only-All Other Plans | $54 | 167% |
| Vchcp-All Plans | $56 | 173% |
| Blue Shield Epn | $114 | 352% |
| Cigna | $148 | 457% |
| Healthnet Comm-All Other Plans | $161 | 497% |
| Kaiser Comm Pediatric Ip/Op Only | $161 | 497% |
| Aetna | $170 - $293 | 525% |
| Blue Shield Comm - All Other Plans | $172 | 531% |
| Blue Cross Blue Shield | $234 | 722% |
| Multiplan/Claritev-All Plans | $234 | 722% |
| Three Rivers Ip/Op Only-All Plans | $234 | 722% |
| Ppo Next Ip/Op Only-All Plans | $264 | 815% |
| Kaiser Mcr Pediatric Ip/Op Only | $293 | 904% |
| Medicare (plans) | $293 | 904% |
| Hpn Comm Ip/Op Only-All Other Plans | $416 | 1284% |