Occupational therapy (self-care training)
Facility: Windham Community Memorial Hospital
Billing Code: 97535 (CPT)
This hospital's typical commercial price is $89 compared to the $65 fair price benchmark.
3-Star CMS clinical quality rating paired with 1.37× fair market pricing.
On the higher side — 6 of 8 other CT hospitals charge less.
Black dot = this hospital, among the 9 CT hospitals with a price for this procedure. Full list below.
A fair price for a Occupational therapy (self-care training) is about $65 (about 2.0× the $32 Medicare rate). Windham Community Memorial Hospital charges insurers about $89, or about $137 in cash — above the fair price. Located in Willimantic, CT.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $65. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $34 | 105% |
| Blue Cross Blue Shieldmajor | $34 - $192 | 105% |
| Aetnamajor | $34 - $225 | 105% |
| Cignamajor | $161 | 497% |
| Molina | $34 - $250 | 105% |
| Tufts Health Plan | $34 | 105% |
| WellCare | $34 | 105% |
| + 1 smaller / regional plan | $34 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Windham Community Memorial Hospital
Compare: Occupational therapy (self-care training) at other CT hospitals
- The Connecticut Hospice Inc. · Branford $20
- Gaylord Hospital · Wallingford $34
- Bristol Hospital · Bristol $36
- St Francis Hospital & Medical Center · Hartford $37
- Saint Mary's Hospital · Waterbury $39
- John Dempsey Hospital of the University of Connect · Farmington $63
- Connecticut Childrens Medical Center · Hartford $94
- Midstate Medical Center · Meriden $97
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Windham Community Memorial Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $50
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $50).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Windham Community Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $137 (vs. $89 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $65 Fair BaseRate ($32 Medicare)
Your bill ($137) is $72 above the denoised Fair BaseRate ($65) and 4.3× the $32 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.