CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: UF Health Shands Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $46
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at UF Health Shands Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.42x the Medicare baseline. Located in 1600 Sw Archer Rd, Gainesville, FL.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $118 (364%)
Insurance Median: $46 (142%)
Cash: $118 (364% of Medicare)
Ins. Median: $46 (142% 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
Aetna $21 - $177 65%
Beacon Health Strategies $21 65%
Humana $21 - $42 65%
Sunshine State Health Plan $21 65%
UnitedHealthcare $21 - $215 65%
Florida Community Care $22 68%
Amerihealth Caritas Florida $23 71%
Community Care Plan $23 71%
Molina $23 71%
Simply Healthcare $24 74%
Blue Cross Blue Shield $41 - $121 127%
Capital Health Plan $41 - $108 127%
North Central Hospice $41 127%
Wellcare $41 127%
Carelon Health $44 136%
Ahf Mco Of Fl $46 142%
Devoted Health Plan $46 142%
Freedom Health- Inc./Optimum Healthcare- Inc. $46 142%
Uaa $82 253%
Ambetter / Centene $86 265%
Northeast Fl Hospital $95 293%
Careplus $97 299%
Positive Healthcare Partners $97 299%
Florida Health Care Plan $108 333%
Wellpath $108 333%
Cigna $122 377%
Health First $150 463%
Prime Health Services $150 463%
Archbold Medical Center $161 497%
Genex $161 497%
Avmed $173 - $189 534%
Corvel Corp $183 565%
Geha $194 599%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Sw Archer Rd, Gainesville, FL 32610
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals