CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: HCA Florida Lawnwood Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $37
  • Cash Discount Price: $423
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at HCA Florida Lawnwood Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $423. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.14x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
$423

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $423 (1306%)
Insurance Median: $37 (114%)
Cash: $423 (1306% of Medicare)
Ins. Median: $37 (114% 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
Careplus $29 - $33 90%
Devoted Health $29 - $34 90%
Humana $29 - $172 90%
Ndms Definitive Care $29 - $33 90%
United $29 - $193 90%
United Behavioral Health $29 - $33 90%
Veterans Evaluation Services $29 - $33 90%
Wellmed $29 - $33 90%
Aetna $30 - $223 93%
Blue Cross Blue Shield $30 - $313 93%
Bright Health $30 - $127 93%
Cigna $30 - $271 93%
Innovage Pace $30 - $34 93%
Kaiser $30 - $150 93%
Mutual Of Omaha $30 - $34 93%
Prominence Healthfirst $30 - $35 93%
Rocky Mountain Health $30 - $34 93%
Sunshine State $30 - $36 93%
Total Longterm Care $30 - $34 93%
Triwest Health Alliance $30 - $34 93%
Ultimate Health Plan $30 - $34 93%
Wellcare $30 - $35 93%
American Health Plan $31 - $35 96%
Delaware Life Insurance $31 - $35 96%
Florida Complete Care $31 - $35 96%
Centurion $32 - $36 99%
Amerihealth Caritas $35 - $39 108%
Longevity Health Plan $35 - $39 108%
Corvel Corporation $37 114%
Freedom Health $37 - $69 114%
Optimum $37 114%
Careworks (Rockport) $38 117%
Prime Health $38 - $381 117%
Solis Health Plan $42 - $48 130%
Vail Health $46 - $64 142%
Avmed $56 - $214 173%
Simply Healthcare Plans $56 173%
Molina $82 - $116 253%
Oscar $82 253%
Health Sun Health Plan $91 281%
Simply Healthcare $101 312%
Sunshine State Health Plan $109 336%
Office Of Sheiff Highland Co $150 463%
United Ppo $189 583%
Western Plains Community Health $195 - $275 602%
Multiplan $210 - $381 648%
Northcare $210 - $296 648%
Physician Health Partners $210 - $296 648%
Plotkin Health $214 660%
Prime Health Sherriff $214 660%
Pinnacol Workers Comp $225 - $317 694%
Medical Development International $240 - $338 741%
Evernorth Bh $343 1059%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals