CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Fairview Park Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $32
Cash Discount Price: $305
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Fairview Park Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 0.99x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.

Cash / Self-Pay

$305

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: $305 (941%)

Insurance Median: $32 (99%)

Cash: $305 (941% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Net	$26 - $30	80%
Aetna	$27 - $168	83%
Coventry	$27 - $31	83%
Devoted Health	$27 - $31	83%
Healthspring	$27 - $31	83%
Hospice Care Options	$27 - $31	83%
Humana	$27 - $31	83%
Southern Care Birmingham	$27 - $31	83%
United	$27 - $137	83%
Wellcare	$27 - $61	83%
Blue Cross Blue Shield	$28 - $32	86%
Clover	$28 - $32	86%
Eon Health	$28 - $32	86%
Georgia Assurance	$28 - $32	86%
Shared Health	$28 - $32	86%
Ryan White Care Act	$40 - $46	123%
Amerigroup	$41	127%
Ambetter / Centene	$45	139%
Friday Health	$46	142%
Nhc Advantage	$58	179%
Pruitt Health	$58	179%
Peach State	$61	188%
Memorial Health Plan	$67 - $137	207%
Cigna	$83 - $111	256%
Centurion	$84	259%
Americas 1St Choice	$85	262%
Leavitt Risk Partners	$92	284%
Health One Alliance	$140	432%
Dodge County Hospital	$152	469%
American Steel Products	$259	799%
City Of Eastman	$259	799%
Dodge Co Board Of Commissioners	$259	799%
Graham Brothers Construction	$259	799%
Multiplan	$274	846%
Novanet	$274	846%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $305.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97535.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fairview Park Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97535.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.