CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Oviedo Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $34
  • Cash Discount Price: $258
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Oviedo Medical Center is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.05x the Medicare baseline. Located in 8300 Red Bug Lake Rd, Oviedo, FL.
Cash / Self-Pay
$258

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $258 (796%)
Insurance Median: $34 (105%)
Cash: $258 (796% of Medicare)
Ins. Median: $34 (105% 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
Freedom Health $18 - $19 56%
Optimum $18 - $19 56%
Avmed $21 - $129 65%
Devoted Health $28 - $32 86%
Humana $28 - $127 86%
Ndms Definitive Care $28 - $32 86%
United $28 - $116 86%
Wellmed $28 - $32 86%
Aetna $29 - $78 90%
Blue Cross Blue Shield $29 - $32 90%
Fl Health Care Plan $29 - $32 90%
Sunshine State $29 - $33 90%
Wellcare $29 - $33 90%
Align Senior Care $30 - $34 93%
American Health Plan $30 - $34 93%
Cigna $30 - $45 93%
Florida Complete Care $30 - $34 93%
Centurion $31 - $35 96%
Clear Spring Health $31 - $35 96%
Gold Kidney Of Florida $31 - $35 96%
Careplus $32 - $36 99%
Ultimate Health Plan $32 - $37 99%
Longevity Health Plan $34 - $38 105%
Prime Health $37 114%
Oscar $41 127%
Solis Health Plan $41 - $46 127%
Simply Healthcare $43 133%
Molina Healthcare $49 151%
Evolutions $59 - $60 182%
Sunshine State Health Plan $65 - $66 201%
Florida Health Care Plan $97 - $98 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8300 Red Bug Lake Rd, Oviedo, FL 32765
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals