CMS Price Transparency Data
Occupational therapy (self-care training)
Facility: Anaheim Global Medical Center
Billing Code: 97535 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97535
- Insurance Median: $36
- Cash Discount Price: $40
- vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Anaheim Global Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.11x the Medicare baseline. Located in 1025 S Anaheim Blvd, Anaheim, CA.
Cash / Self-Pay
$40
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: $40 (123%)
Insurance Median: $36 (111%)
Cash: $40 (123% 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 |
|---|---|---|
| Altamed Mcal Hmo (Ancillary) | $5 | 15% |
| Healthcare Partners | $5 | 15% |
| Hollywood Presbyterian | $5 | 15% |
| Kaiser | $5 - $36 | 15% |
| Medi-Cal Hmo/Non Contract | $5 | 15% |
| Prime Health Services | $5 - $41 | 15% |
| State Of California | $5 - $33 | 15% |
| Brand New Day | $6 - $45 | 19% |
| Altamed | $7 - $36 | 22% |
| Caloptima | $7 - $36 | 22% |
| Choc Health Alliance | $7 | 22% |
| County Of Orange | $7 - $45 | 22% |
| Family Choice Mcal | $7 | 22% |
| Heritage Provider Network | $7 - $36 | 22% |
| Prospect Health Plan | $7 - $54 | 22% |
| Ihhi Reciprocity | $12 | 37% |
| Velocity National Provider Network Auto Med Ppo | $18 | 56% |
| First Health | $21 | 65% |
| Magellan Behavioral Health | $24 | 74% |
| Primecare Medical Network Inc | $24 | 74% |
| Cigna | $26 - $315 | 80% |
| Health Net | $28 - $62 | 86% |
| Health Net Inc | $28 - $36 | 86% |
| Multiplan | $28 - $33 | 86% |
| Networks By Design | $28 | 86% |
| Coventry Health | $30 - $31 | 93% |
| Healthsmart Preferred Network | $30 | 93% |
| Interplan | $30 | 93% |
| Provider Network Of America | $32 | 99% |
| Three Rivers Network | $33 - $63 | 102% |
| Velocity National Provider Network Wc | $33 | 102% |
| Altamed Health Services | $34 - $36 | 105% |
| Champus | $34 | 105% |
| Aetna | $36 - $65 | 111% |
| Astiva | $36 | 111% |
| Blue Shield Of California | $36 - $137 | 111% |
| California Health Plan | $36 | 111% |
| Central Health Plan Of California Inc | $36 | 111% |
| Champion Health Plan | $36 | 111% |
| Choice Physicians Network | $36 | 111% |
| Citizens Choice | $36 | 111% |
| Clever Care Health Plan | $36 | 111% |
| Easy Choice | $36 | 111% |
| For Your Benefit | $36 | 111% |
| Healthcare Partners Sr Hmo | $36 | 111% |
| Hollywood Presbyerian | $36 | 111% |
| Humana | $36 | 111% |
| Imperial Health Plan Of Ca | $36 | 111% |
| Innovative Integrated Health | $36 | 111% |
| Medcare Partners Health Plan | $36 | 111% |
| Medicare (plans) | $36 | 111% |
| Monarch | $36 | 111% |
| Onecare | $36 | 111% |
| Other Sr Non Contract | $36 | 111% |
| Physicians For Healthy Hospitals | $36 | 111% |
| Scan | $36 | 111% |
| Self Pay/Ab774/Cbo Use Only | $36 | 111% |
| St Joseph Hospital Sr | $36 | 111% |
| UnitedHealthcare | $36 - $220 | 111% |
| Us Dept Of Labor | $36 | 111% |
| Us Federal Marshall/Department Of Immigration | $36 | 111% |
| Velocity National Provider Network Sr | $36 | 111% |
| Verda Health Plan | $36 | 111% |
| Veterans Administration | $36 | 111% |
| Victim Of Violent Crime | $36 | 111% |
| Victim Of Violent Crime (Mep) | $36 | 111% |
| Victoria Hospice | $36 | 111% |
| Healthcare Partners Hmo | $39 | 120% |
| Ahmc Healthcare | $40 | 123% |
| Align Sr Care | $40 | 123% |
| Lucet Bh Scan Sr | $40 | 123% |
| Managed Health Network | $40 | 123% |
| Naphcare | $40 | 123% |
| Other Insurance Loa | $40 | 123% |
| Other Non Contracted Plans | $40 | 123% |
| Private Pay | $40 | 123% |
| Usbhpc | $40 | 123% |
| Veterans Evaluation Services | $45 | 139% |
| Staywell/Island Home Ins | $50 | 154% |
| Velocity National Provider Network Ppo | $63 | 194% |
| Monarch Health Plan | $142 - $179 | 438% |