CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: HCA Florida Kendall Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $38
  • Cash Discount Price: $609
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at HCA Florida Kendall Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $609. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.17x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.
Cash / Self-Pay
$609

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $609 (1880%)
Insurance Median: $38 (117%)
Cash: $609 (1880% of Medicare)
Ins. Median: $38 (117% 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
Humana $29 - $207 90%
Aetna $30 - $183 93%
Blue Cross Blue Shield $30 - $34 93%
Careplus Sfl $30 - $34 93%
Cigna $30 - $128 93%
Devoted Health $30 - $34 93%
Leon Health $30 - $34 93%
Ndms Definitive Care $30 - $34 93%
United $30 - $274 93%
United Behavioral Health $30 - $34 93%
Veterans Evaluation Services $30 - $34 93%
Wellmed $30 - $34 93%
American Health Plan $31 - $36 96%
Oscar $31 - $97 96%
Prominence Healthfirst $31 - $35 96%
Sunshine State $31 - $37 96%
Align $32 - $36 99%
Avmed $32 - $304 99%
Florida Complete Care $32 - $36 99%
Centurion $33 - $37 102%
Doctors Healthcare Plan $33 - $37 102%
Gold Kidney $33 - $38 102%
Amerihealth Caritas $35 - $104 108%
Longevity Health Plan $35 - $40 108%
Corvel Corporation $38 117%
Careworks (Rockport) $39 120%
Prime Health $39 120%
Solis Health Plan $43 - $49 133%
Naphcare $50 - $57 154%
Freedom Health $52 - $97 160%
Optimum $52 160%
Seven Corners $62 - $81 191%
Wellpath $62 - $81 191%
Simply Healthcare Plans $79 244%
Simply Healthcare $82 253%
Molina $116 - $164 358%
Health Sun Health Plan $130 401%
Aids Healthcare $134 - $731 414%
Mmm Of Fl (Health Advantage Plan) $140 432%
United Ppo $144 444%
Sunshine State Health Plan $158 488%
Plotkin Health $304 938%
Prime Health Sherriff $304 938%
Medica Healthcare $353 1090%
Multiplan $457 - $518 1410%
Evernorth Bh $487 1503%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11750 Bird Rd, Miami, FL 33175
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals