CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Parrish Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $133
Cash Discount Price: $89
vs. Medicare Baseline: 4.10x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Parrish Medical Center is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 4.10x the Medicare baseline. Located in 951 N Washington Ave, Titusville, FL.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$133

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: $89 (275%)

Insurance Median: $133 (410%)

Cash: $89 (275% of Medicare)

Ins. Median: $133 (410% 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 410% of the Medicare baseline (a markup of 310%). 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
Florida Health Care Plan	$17	52%
Veterans	$24	74%
Webtpa	$30	93%
Careplus Health Plans Inc.	$31	96%
Freedom Health	$31	96%
Health First Health Plans	$31 - $222	96%
Medicare (plans)	$31	96%
Tricare	$31	96%
Cigna	$32 - $155	99%
UnitedHealthcare	$33 - $484	102%
Aetna	$38 - $149	117%
Blue Cross Blue Shield	$39 - $173	120%
Corvel Healthcare Corporation	$40	123%
Florida Health Care Plan Commercial	$40 - $134	123%
Humana	$46 - $111	142%
Auto	$64	198%
Pmc Hpi Employee Plan	$84	259%
Pmc Preferred Benefit Administrators	$84	259%
Brevard County Commissioners	$107	330%
Brevard School Board	$107	330%
Coventry Healthcare	$200	617%
Coventry Helthcare Inc	$200	617%
First Health Group Corp	$200	617%
Beech Street Corporation	$211	651%
Multiplan Inc	$211	651%
Private Healthcare Systems Inc	$211	651%
Early Steps	$222	685%
No Contract	$222	685%
Self Pay	$222	685%

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 $89.
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 Parrish 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.