Occupational therapy (self-care training)
Facility: Glendale Adventist Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $146
- Cash Discount Price: $46
- vs. Medicare Baseline: 4.51x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 451% of the Medicare baseline (a markup of 351%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 Medi-Cal | $7 | 22% |
| Heritage Mcal | $8 | 25% |
| Medi-Cal | $8 | 25% |
| Molina Mcal | $8 | 25% |
| Healthnet Mcal | $9 | 28% |
| Blue Shield Medi-Cal | $19 | 59% |
| Blue Shield Mcr Adv | $36 | 111% |
| Clever Care Mcr Adv - All Plans | $36 | 111% |
| Molina Mcr | $36 | 111% |
| Regal Med Group Mcal | $36 | 111% |
| Tricare | $36 | 111% |
| UnitedHealthcare | $36 - $181 | 111% |
| Blue Cross Blue Shield | $37 - $446 | 114% |
| Regal Medical Group Commercial - All Other Plans | $43 | 133% |
| Dept Of State Hsp Metropolitan- All Plans | $47 | 145% |
| Molina Exchange - All Other Plans | $49 | 151% |
| Ah Employee Health Plan - All Plans | $65 | 201% |
| Kaiser - All Plans | $73 - $146 | 225% |
| Centivo - All Plans | $81 | 250% |
| Phys Assoc Op Only- All Plans | $92 | 284% |
| Aetna | $119 | 367% |
| Employers Health Network - All Plans | $125 | 386% |
| Healthcare Partners- All Plans | $145 | 448% |
| Cigna | $147 | 454% |
| Caremore Mcr Adv - All Plans | $154 | 475% |
| La Care Mcr Adv- All Plans | $168 | 519% |
| Healthnet - All Other Plans | $172 | 531% |
| First Health- All Plans | $177 | 546% |
| Phcs- All Plans | $198 | 611% |
| Scan Mcr Adv - All Plans | $198 | 611% |
| Heritage Sr | $213 | 657% |
| Beech Street - All Plans | $229 | 707% |
| Choicecare - All Plans | $229 | 707% |
| Heritage Commercial - All Other Plans | $239 | 738% |
| Corvel- All Plans | $244 | 753% |
| Health Mgmt Network - All Plans | $259 | 799% |
| Three Rivers - All Plans | $259 | 799% |
| Alignment Hp Mcr Adv - All Plans | $305 | 941% |
| Blue Shield Epn - All Other Plans | $327 | 1009% |
| Western Growers/Pinnacle - All Plans | $341 | 1052% |
| Blue Shield Non Epn | $376 | 1160% |
| Healthnet Mcr Adv | $433 | 1336% |