CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: HCA Florida Trinity Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $32
  • Cash Discount Price: $347
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at HCA Florida Trinity Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $347. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 0.99x the Medicare baseline. Located in 9330 Sr 54, Trinity, FL.
Cash / Self-Pay
$347

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $347 (1071%)
Insurance Median: $32 (99%)
Cash: $347 (1071% of Medicare)
Ins. Median: $32 (99% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members $16 49%
Access 2 Healthcare Physicians Freedom Health $25 77%
Access 2 Healthcare Physicians Optimum $25 77%
Freedom Health Care $27 83%
Optimum Healthcare $27 83%
Aetna $28 - $104 86%
Avmed $28 - $87 86%
Devoted Health $28 - $32 86%
Hernando-Pasco Hospice $28 - $32 86%
Ndms Definitive Care $28 - $32 86%
Sunshine State $28 - $32 86%
United $28 - $156 86%
United Behavioral Health $28 - $32 86%
United Va Ccn $28 - $32 86%
Wellcare $28 - $32 86%
Wellmed $28 - $32 86%
Baycare Health Plans $29 - $33 90%
Blue Cross Blue Shield $29 - $32 90%
Humana $29 - $97 90%
Ultimate Health Plan $29 - $32 90%
Align Senior Care $30 - $34 93%
American Health Plan $30 - $34 93%
Cigna $30 - $62 93%
Florida Complete Care $30 - $34 93%
Secur $30 - $34 93%
Caresource $31 96%
Centurion $31 - $35 96%
Clear Spring Health $31 - $35 96%
Gold Kidney Of Florida $31 - $35 96%
Pasco Sheriff'S Office $31 - $35 96%
Careplus $32 - $36 99%
Longevity Health Plan $34 - $38 105%
Corvel Corporation $36 111%
Rockport Healthcare Group $36 111%
Prime Health $37 114%
Solis Health Plan $41 - $46 127%
Simply Healthcare $44 - $53 136%
Oscar $52 160%
Molina $66 - $94 204%
Evolutions Healthcare Systems $80 - $319 247%
Sunshine State Health Plan $88 272%
Beacon Health Options $173 534%
Plotkin Health $173 534%
Prime Health Sheriff $173 534%
Multiplan $260 - $295 802%
Evernorth $277 855%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9330 Sr 54, Trinity, FL 34655
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals