CMS Price Transparency Data
Occupational therapy (self-care training)
Facility: Monterey Park Hospital
Billing Code: 97535 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97535
- Insurance Median: $36
- Cash Discount Price: $200
- vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Monterey Park Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.11x the Medicare baseline. Located in 900 S Atlantic Blvd, Monterey Park, CA.
Cash / Self-Pay
$200
Average discount available for prompt cash payment at this facility.
Insurance Median
$36
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: $200 (617%)
Insurance Median: $36 (111%)
Cash: $200 (617% of Medicare)
Ins. Median: $36 (111% 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 |
|---|---|---|
| Access Ipa Ancillary | $5 - $36 | 15% |
| Accountable Ipa | $5 | 15% |
| Ahmc Healthcare Inc | $5 - $60 | 15% |
| Aids Health Foundation | $5 - $35 | 15% |
| Alhambra Community Dialysis Unit Inc | $5 - $120 | 15% |
| Allied Physicians | $5 - $54 | 15% |
| Alta Med Health Services Corp | $5 - $50 | 15% |
| Altamed Health Network | $5 - $35 | 15% |
| Altamed Health Services | $5 | 15% |
| Applecare Medical Group | $5 - $29 | 15% |
| Assess Ipa | $5 | 15% |
| Associated Hispanic Physicians Ancillary | $5 - $28 | 15% |
| Avanti | $5 - $43 | 15% |
| Bella Vista Medical Group Ancillary | $5 | 15% |
| Beverly Hospital | $5 - $40 | 15% |
| Blue Cross Blue Shield | $5 - $231 | 15% |
| Brand New Day | $5 - $45 | 15% |
| Care 1St Mcl/Gar Cap | $5 | 15% |
| Central Health Plan | $5 | 15% |
| Community Health Plan | $5 | 15% |
| Emanate Health | $5 - $45 | 15% |
| Esperanza Medical Group Ipa | $5 - $60 | 15% |
| Family Health Alliance Medical Group | $5 - $60 | 15% |
| Health Net Medi Cal | $5 | 15% |
| Healthnet Inc | $5 | 15% |
| Healthy Way La | $5 | 15% |
| Hollywood Presbyterian Adv Med Mcal | $5 | 15% |
| Hollywood Presbyterian Medpoint Mcal | $5 | 15% |
| La Care | $5 - $36 | 15% |
| La Care Health Plan | $5 - $110 | 15% |
| Maxi Med Inc/Ipa | $5 - $36 | 15% |
| Medi Cal | $5 | 15% |
| Medical Managed Care Program | $5 | 15% |
| Molina Healthcare | $5 | 15% |
| Other Non-Contracted Medi-Cal | $5 | 15% |
| Pacific Independent Physician Association | $5 - $60 | 15% |
| Preferred Ipa | $5 - $45 | 15% |
| Preferred Ipa Of California | $5 | 15% |
| Caloptima Direct | $8 | 25% |
| Altamed Health Services Corporation | $20 | 62% |
| Care 1St M Cal | $20 | 62% |
| Crown City Medical Group Inc | $20 | 62% |
| Physician Healthways | $20 - $55 | 62% |
| Universal Care M Cal/Advantage Health Network | $20 | 62% |
| Veterans Administration | $25 | 77% |
| Bella Vista Medical Group | $29 - $60 | 90% |
| Interplan | $32 - $150 | 99% |
| Preferred Health Network | $32 - $160 | 99% |
| Senior Citizens Choice | $32 | 99% |
| Aetna | $33 - $146 | 102% |
| Asi Flex Ppo W/C | $33 | 102% |
| Athens Administrators | $33 | 102% |
| Indemnity W Comp Fee Schedule | $33 | 102% |
| Multiplan | $33 - $170 | 102% |
| Alignment Health Plan | $35 | 108% |
| Apa/Aco Inc | $35 | 108% |
| Blue Shield Of California | $35 - $433 | 108% |
| Cms | $35 | 108% |
| Easy Choice Health Plan | $35 | 108% |
| First Health Senior | $35 | 108% |
| Foundation Health Plan | $35 | 108% |
| Health Net | $35 - $135 | 108% |
| Health Net Inc | $35 - $234 | 108% |
| Humana | $35 | 108% |
| Medicare (plans) | $35 - $37 | 108% |
| Scan Health Plan | $35 | 108% |
| Secure Horizons | $35 | 108% |
| Ucla/Impact Cancer | $35 | 108% |
| UnitedHealthcare | $35 - $140 | 108% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $36 | 111% |
| La Care Covered Direct | $36 | 111% |
| Self-Pay | $36 | 111% |
| Molina Healthcare Medi-Connect | $37 | 114% |
| Employee Health Systems Medical Group | $40 | 123% |
| Global Care Medical Group Ipa | $40 - $90 | 123% |
| Healthnet/Ehs Capitation | $40 | 123% |
| San Miguel Health Plan | $40 | 123% |
| Ahmc Health Epo | $45 | 139% |
| Knox-Keene Act | $45 | 139% |
| Molina Healthcare Of California | $45 | 139% |
| Hispanic Physicians Ipa Medical Corporation | $50 | 154% |
| Garfield Medical Center | $54 | 167% |
| Ahmc Reciprocity Agreement Senior/Commercial | $60 | 185% |
| Allied Physicians Ipa | $60 | 185% |
| Community Health Plan M Cal Joy Ipa | $60 | 185% |
| Tenet Reciprocity | $60 | 185% |
| Healthcare Partners Affiliates Medical Group | $71 | 219% |
| Molina Medical Centers | $78 | 241% |
| Central Health Plan Of California | $80 | 247% |
| Health Net Of California | $107 - $120 | 330% |
| Care 1St Health Plan | $120 | 370% |
| Greater Los Angeles Dialysis Inc | $120 | 370% |
| One Health Plan | $120 - $775 | 370% |
| Choice Care Network | $130 | 401% |
| Healthnet | $130 | 401% |
| Universal Care | $140 | 432% |
| Corvel Corporation | $160 - $925 | 494% |
| Bce Emergis Corp | $170 | 525% |
| Commercial Non Contract | $200 | 617% |
| Mri/Ct Greater El Monte Hospital | $200 | 617% |
| Mri/Mra/Alhambra Hospital | $200 | 617% |
| Mri/Mra/Eladh | $200 | 617% |
| One Legacy | $200 | 617% |
| Pacificare | $219 - $263 | 676% |
| Cigna | $525 | 1620% |