CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Glenn Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $95
Cash Discount Price: $65
vs. Medicare Baseline: 2.93x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Glenn Medical Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 2.93x the Medicare baseline. Located in 1133 W Sycamore St, Willows, CA.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $65 (201%)

Insurance Median: $95 (293%)

Cash: $65 (201% of Medicare)

Ins. Median: $95 (293% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 293% of the Medicare baseline (a markup of 193%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Ca Health And Wellness - All Plans	$8	25%
Medi-Cal	$8	25%
UnitedHealthcare	$29 - $98	90%
Humana	$37 - $48	114%
Blue Cross Blue Shield	$38 - $110	117%
Blue Shield Exch	$78 - $99	241%
Cigna	$82 - $104	253%
First Health - All Plans	$82 - $104	253%
Healthnet - All Plans	$82 - $104	253%
Beech Street - All Plans	$86 - $110	265%
Blue Shield Ppo/Hmo - All Other Plans	$86 - $110	265%
Dept Of Corrections - All Plans	$86 - $110	265%
Galaxy Health Network - All Plans	$86 - $110	265%
Interplan - All Plans	$86 - $110	265%
Pacific Health Alliance - All Plans	$86 - $110	265%
Pponext - All Plans	$86 - $110	265%
Superior Ca Ppo - All Plans	$86 - $110	265%
Integrated Hp - All Plans	$89 - $113	275%
Health Mgmt Network - All Plans	$91 - $116	281%
Networks By Design - All Plans	$91 - $116	281%
Three Rivers - All Plans	$91 - $116	281%

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 $65.
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 Glenn 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.