Occupational therapy (self-care training)
Facility: Central Florida Lake Monroe Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $45
- Cash Discount Price: $280
- vs. Medicare Baseline: 1.39x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Freedom Health | $20 | 62% |
| Optimum | $20 | 62% |
| Devoted Health | $28 - $32 | 86% |
| Humana | $28 - $127 | 86% |
| Ndms Definitive Care | $28 - $32 | 86% |
| United | $28 - $127 | 86% |
| Wellmed | $28 - $32 | 86% |
| Aetna | $29 - $85 | 90% |
| Blue Cross Blue Shield | $29 - $32 | 90% |
| Fl Health Care Plan | $29 - $32 | 90% |
| Sunshine State | $29 - $33 | 90% |
| Wellcare | $29 - $33 | 90% |
| Align Senior Care | $30 - $34 | 93% |
| American Health Plan | $30 - $34 | 93% |
| Avmed | $30 - $141 | 93% |
| Cigna | $30 - $49 | 93% |
| Florida Complete Care | $30 - $34 | 93% |
| Centurion | $31 - $35 | 96% |
| Clear Spring Health | $31 - $35 | 96% |
| Gold Kidney Of Florida | $31 - $35 | 96% |
| Seminole County Sheriffs Office | $31 - $35 | 96% |
| Careplus | $32 - $36 | 99% |
| Ultimate Health Plan | $32 - $37 | 99% |
| Longevity Health Plan | $34 - $38 | 105% |
| Corvel Corporation | $36 | 111% |
| Prime Health | $37 | 114% |
| Careworks (Rockport Community) | $38 | 117% |
| Solis Health Plan | $41 - $46 | 127% |
| Oscar | $44 - $45 | 136% |
| Simply Healthcare | $46 - $47 | 142% |
| Molina Healthcare | $53 - $90 | 164% |
| Evolutions | $64 - $65 | 198% |
| Sunshine State Health Plan | $71 - $72 | 219% |
| Florida Health Care Plan | $104 - $106 | 321% |
| Plotkin Health | $138 - $141 | 426% |
| Prime Health Sheriff | $138 - $141 | 426% |
| Multiplan | $208 - $240 | 642% |
| Three Rivers Provider Network | $208 - $212 | 642% |
| Ppo Next | $235 - $240 | 725% |
| Novanet | $249 - $254 | 769% |