Occupational therapy (self-care training)
Facility: Larkin Community Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $67
- Cash Discount Price: $122
- vs. Medicare Baseline: 2.07x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 207% of the Medicare baseline (a markup of 107%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Medicaid / KanCare | $13 - $20 | 40% |
| Corvel Mcaid Workers Comp | $17 | 52% |
| Sunshine Behavioral | $17 | 52% |
| Aetna | $19 - $177 | 59% |
| Ambetter / Centene | $19 | 59% |
| Community Care Phks Mcaid-All Other Plans | $19 | 59% |
| Florida Comm Care Mcaid | $19 | 59% |
| Humana | $19 - $177 | 59% |
| Magellan Complete Care | $19 | 59% |
| Molina Exch Marketplace-All Other Plans | $19 | 59% |
| UnitedHealthcare | $19 - $100 | 59% |
| Blue Cross Blue Shield | $31 - $258 | 96% |
| Florida Comm Care Mcare-All Other Plans | $33 | 102% |
| Medicare (plans) | $33 - $186 | 102% |
| Ops Maritime-All Plans | $33 | 102% |
| Opus Hospice Ip Only-All Plans | $33 | 102% |
| Preferred Care Partners Mcare-All Plans | $33 | 102% |
| Clear Springs Hlth-All Plans | $35 | 108% |
| Unicare Simply Mcare Ppo-All Plans | $35 | 108% |
| Wellpath-All Plans | $36 | 111% |
| Fci-All Plans | $38 | 117% |
| Allianz (Azga)-All Plans | $43 | 133% |
| Cigna | $43 - $44 | 133% |
| Healthsun-All Plans | $51 - $53 | 157% |
| United Prop Casualty-All Plans | $65 | 201% |
| Star Network-All Plans | $68 - $71 | 210% |
| Jmh Health Plan Hmo/Ppo-All Other Plans | $75 | 231% |
| Global Excel-All Plans | $103 - $106 | 318% |
| Haa Preferred Partners-All Plans | $103 - $106 | 318% |
| Corvel Mcare Workers Comp-All Plans | $154 - $159 | 475% |
| Avmed-All Plans | $171 - $177 | 528% |
| Careplus Health-All Other Plans | $171 - $177 | 528% |
| Centurion-All Plans | $171 - $177 | 528% |
| Coventry Comml-All Plans | $171 - $177 | 528% |
| Doctors Healthcare-All Plans | $171 - $177 | 528% |
| First Med Hp Of Fl-All Plans | $171 - $177 | 528% |
| Florida Health Solution/Hmo-All Plans | $171 - $177 | 528% |
| Bright Health-All Other Plans | $205 - $212 | 633% |
| Oscar Health-All Plans | $342 - $354 | 1056% |