CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: College Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $36
Cash Discount Price: $278
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at College Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $278. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.11x the Medicare baseline. Located in 2776 Pacific Avenue, Long Beach, CA.

Cash / Self-Pay

$278

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: $278 (858%)

Insurance Median: $36 (111%)

Cash: $278 (858% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$28 - $36	86%
Accountable Healthcare Ipa	$29 - $36	90%
Imperial Health Plan	$29	90%
Altamed	$36	111%
Benevolence Healthcare	$36	111%
Blue Cross Blue Shield	$36 - $2,969	111%
Blue Shield	$36 - $250	111%
Brand New Day	$36	111%
Care First	$36	111%
Caremore	$36	111%
Central Health Plan	$36	111%
Easy Choice	$36	111%
Health Net	$36 - $241	111%
Heritage Provider Network	$36 - $50	111%
Kaiser	$36 - $223	111%
La Care	$36	111%
Molina Healthcare	$36	111%
Prospect	$36	111%
Synermed	$36 - $50	111%
Three Rivers Provider Network	$48	148%
Cigna	$115	355%
Davita Healthplan	$127	392%
Healthcare Partners	$127	392%
Value Options	$186	574%
Multiplan	$315	972%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $278.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97535.

Insurance In-Network Protection Plan

Contact your insurance company to confirm College Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97535.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.