CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: HCA Florida Pasadena Hospital A Part of HCA Florid

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $64
Cash Discount Price: $388
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at HCA Florida Pasadena Hospital A Part of HCA Florid is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $388. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.98x the Medicare baseline. Located in 1501 Pasadena Ave S, Saint Petersburg, FL.

Cash / Self-Pay

$388

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $388 (1198%)

Insurance Median: $64 (198%)

Cash: $388 (1198% of Medicare)

Ins. Median: $64 (198% 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.

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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$10 - $20	31%
Blue Cross Blue Shield	$11 - $20	34%
Aetna	$15 - $128	46%
Access 2 Healthcare Physicians Freedom Health	$16 - $31	49%
Access 2 Healthcare Physicians Optimum	$16 - $31	49%
Freedom Health Care	$17 - $33	52%
Optimum Healthcare	$17 - $33	52%
Avmed	$18 - $106	56%
Simply Healthcare	$28 - $65	86%
Humana	$30 - $119	93%
Oscar	$33 - $64	102%
Corvel Corporation	$36	111%
Rockport Healthcare Group	$36	111%
United	$36 - $191	111%
Prime Health	$37	114%
Cigna	$40 - $76	123%
Molina	$42 - $115	130%
Evolutions Healthcare Systems	$51 - $391	157%
Sunshine State Health Plan	$56 - $108	173%
Plotkin Health	$110 - $212	340%
Prime Health Sheriff	$110 - $212	340%
Multiplan	$165 - $361	509%

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 $388.
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 HCA Florida Pasadena Hospital A Part of HCA Florid 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.