CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Jeff Davis Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $56
Cash Discount Price: $26
vs. Medicare Baseline: 1.73x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Jeff Davis Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.73x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.

Cash / Self-Pay

$26

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $26 (80%)

Insurance Median: $56 (173%)

Cash: $26 (80% of Medicare)

Ins. Median: $56 (173% 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
Humana	$15 - $64	46%
Medicaid / KanCare	$15 - $40	46%
Peach_State	$15	46%
Wellcare	$15	46%
Medicare (plans)	$23	71%
Blue Cross Blue Shield	$24 - $56	74%
Care_Improvement_Plus	$24	74%
Pen_Network	$47	145%
Coventry_Hmo	$52	160%
Coventry_Pos	$52	160%
Uhc_Hmo	$56	173%
Uhc_Indemnity	$56	173%
Uhc_Ppo	$56	173%
Coventry_Ppo	$58	179%
Beech_Street	$60	185%
Care_Source	$60	185%
Cigna	$60	185%
One_Health_Ppo	$60	185%
Choicecare	$64	198%
Community_Care_Network	$64	198%
Georgia_Hospital_Network	$64	198%
Industry_Buying_Group	$64	198%
Novanet	$64	198%
Principal_Health_Care_Of_Georgia	$64	198%
Three_Rivers_Provider_Network	$64	198%
Usa_Managed_Care	$64	198%
Memorial_Health_Partners	$68	210%
Tricare	$70	216%
Multiplan	$71	219%

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 $26.
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 Jeff Davis 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.