CMS Price Transparency Data
Occupational therapy (self-care training)
Facility: St Francis Hospital
Billing Code: 97535 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$56
about 1.8× the $32 Medicare rate · typically $36–$214
modeled estimate · not a bill or quote
Medicare pays $32 Fair price $56 Cash price $116 Hospital's list price $178
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
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente
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 | $166 - $176 | 512% |
| Blue Cross Blue Shieldmajor | $32 - $214 | 99% |
| Aetnamajor | $34 - $119 | 105% |
| Cignamajor | $33 - $113 | 102% |
| AmeriHealth | $51 - $178 | 157% |
| GEHA | $166 - $176 | 512% |
| + 5 smaller / regional plans | $112 - $404 |
Government programs also on file: Medicare, Medicaid.
Excludes 7 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at St Francis Hospital
Compare: Occupational therapy (self-care training) at other DE hospitals
- PAM Rehabilitation Hospital of Dover · Dover $31
- PAM Health Rehabilitation Hospital of Georgetown · Georgetown $33
- Christiana Hospital · Newark $35
- Bayhealth Medical Center, Kent Campus · Dover $51
- Bayhealth Hospital, Sussex Campus · Milford $51
- Nemours Children's Hospital, Delaware · Wilmington $55
- Tidalhealth Nanticoke, Inc. · Seaford $65
Insurance negotiated median for the same procedure, sorted lowest first.