CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: The Medical Center of Aurora & South Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $34
  • Cash Discount Price: $304
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at The Medical Center of Aurora & South Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $304. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.05x the Medicare baseline. Located in 1501 S Potomac St, Aurora, CO.
Cash / Self-Pay
$304

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $304 (938%)
Insurance Median: $34 (105%)
Cash: $304 (938% of Medicare)
Ins. Median: $34 (105% 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
Humana $29 - $33 90%
United $29 - $137 90%
Aetna $30 - $161 93%
Blue Cross Blue Shield $30 - $225 93%
Bright Health $30 - $91 93%
Cigna $30 - $195 93%
Devoted Health $30 - $34 93%
Kaiser $30 - $108 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 $46 142%
Colorado Program For Children With Special Needs $128 395%
Western Plains Community Health $198 611%
Multiplan $213 - $274 657%
Northcare $213 657%
Physician Health Partners $213 657%
Pinnacol Workers Comp $228 704%
Medical Development International $243 750%
Prime Health $274 846%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1501 S Potomac St, Aurora, CO 80012
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals