Occupational therapy (self-care training)
Facility: HCA Healthone Presbyterian St Luke's
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $51
- Cash Discount Price: $257
- vs. Medicare Baseline: 1.57x 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.
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 |
|---|---|---|
| UnitedHealthcare | $25 - $29 | 77% |
| Humana | $29 - $34 | 90% |
| United | $29 - $118 | 90% |
| Aetna | $30 - $138 | 93% |
| Blue Cross Blue Shield | $30 - $194 | 93% |
| Bright Health | $30 - $79 | 93% |
| Cigna | $30 - $168 | 93% |
| Devoted Health | $30 - $34 | 93% |
| Innovage Pace | $30 - $34 | 93% |
| Kaiser | $30 - $68 | 93% |
| Kaiser National Transplant | $30 - $126 | 93% |
| Mutual Of Omaha | $30 - $34 | 93% |
| Rocky Mountain Health | $30 - $34 | 93% |
| Total Longterm Care | $30 - $34 | 93% |
| Triwest Health Alliance | $30 - $34 | 93% |
| Wellcare | $30 - $35 | 93% |
| Delaware Life Insurance | $31 - $35 | 96% |
| Vail Health | $38 - $40 | 117% |
| Emerging Therapy Solutions | $121 - $168 | 373% |
| Colorado Program For Children With Special Needs | $129 - $133 | 398% |
| Western Plains Community Health | $164 - $170 | 506% |
| Multiplan | $177 - $236 | 546% |
| Northcare | $177 - $183 | 546% |
| Physician Health Partners | $177 - $183 | 546% |
| Pinnacol Workers Comp | $189 - $196 | 583% |
| Medical Development International | $202 - $209 | 623% |
| Prime Health | $227 - $236 | 701% |