Occupational therapy (self-care training)
Facility: HCA Florida Sarasota Doctors Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $54
- Cash Discount Price: $682
- vs. Medicare Baseline: 1.67x 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 |
|---|---|---|
| Aetna | $28 - $209 | 86% |
| Ndms Definitive Care | $28 - $32 | 86% |
| United | $28 - $314 | 86% |
| United Behavioral Health | $28 - $32 | 86% |
| United Va Ccn | $28 - $32 | 86% |
| Wellmed | $28 - $32 | 86% |
| Blue Cross Blue Shield | $29 - $32 | 90% |
| Humana | $29 - $195 | 90% |
| Sunshine State | $29 - $33 | 90% |
| Ultimate Health Plan | $29 - $32 | 90% |
| Wellcare | $29 - $33 | 90% |
| Align Senior Care | $30 - $34 | 93% |
| American Health Plan | $30 - $34 | 93% |
| Cigna | $30 - $121 | 93% |
| Florida Complete Care | $30 - $34 | 93% |
| Secur | $30 - $34 | 93% |
| Access 2 Healthcare Physicians Freedom Optimum Group Members | $31 - $33 | 96% |
| Caresource | $31 | 96% |
| Centurion | $31 - $35 | 96% |
| Clear Spring Health | $31 - $35 | 96% |
| Gold Kidney Of Florida | $31 - $35 | 96% |
| Corvel Corporation | $36 | 111% |
| Rockport Healthcare Group | $36 | 111% |
| Prime Health | $37 | 114% |
| Access 2 Healthcare Physicians Freedom Health | $48 - $50 | 148% |
| Access 2 Healthcare Physicians Optimum | $48 - $50 | 148% |
| Freedom Health Care | $52 - $54 | 160% |
| Optimum Healthcare | $52 - $54 | 160% |
| Avmed | $53 - $174 | 164% |
| Simply Healthcare | $98 - $107 | 302% |
| Oscar | $100 - $105 | 309% |
| Molina | $127 - $188 | 392% |
| Evolutions Healthcare Systems | $153 - $642 | 472% |
| Sunshine State Health Plan | $170 - $178 | 525% |
| Behealthy America | $260 - $272 | 802% |
| Beacon Health Options | $333 - $349 | 1028% |
| Healthcare Sarasota | $333 - $349 | 1028% |
| Plotkin Health | $333 - $349 | 1028% |
| Prime Health Sheriff | $333 - $349 | 1028% |
| Multiplan | $500 - $593 | 1543% |
| Evernorth | $533 - $558 | 1645% |