CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Mercyone Des Moines Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $30
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Mercyone Des Moines Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 0.93x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $66 (204%)
Insurance Median: $30 (93%)
Cash: $66 (204% of Medicare)
Ins. Median: $30 (93% 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
Medicaid / KanCare $21 - $66 65%
Aetna $22 - $66 68%
Albany County Correctional Facility $23 - $28 71%
Ambetter / Centene $23 - $52 71%
Amish Mennonite $23 - $28 71%
Ascension St. Vincent Public Safety Medical $23 - $28 71%
Bcccp-Michigan $23 - $28 71%
Bccp $23 - $28 71%
Blue Cross Blue Shield $23 - $45 71%
Bmc Healthnet $23 - $28 71%
Breast Grant-Connecticut $23 - $28 71%
Broward County Dept Of Health $23 - $28 71%
California Health And Wellness $23 - $28 71%
Can Community Health Inc $23 - $28 71%
Cardinal Innovations Lme $23 - $28 71%
Care Connections Of Northern Iowa $23 - $28 71%
Care Oregon Ohp $23 - $28 71%
Cencal Health Plan $23 - $28 71%
Cenpatico $23 - $28 71%
Chhuny $23 - $28 71%
Childrens Comm Health Plan $23 - $28 71%
Childrens Medical Services Title 19 $23 - $28 71%
Cigna $23 - $96 71%
City Of Philadelphia $23 - $28 71%
Cmh Allegan County $23 - $28 71%
Cmh Ausable Valley $23 - $28 71%
Cmh Barry County $23 - $28 71%
Cmh Bay-Arenac County $23 - $28 71%
Cmh Berrien County $23 - $28 71%
Cmh Cass County $23 - $28 71%
Cmh Central Mi County $23 - $28 71%
Cmh Clinton-Eaton-Ingham County $23 - $28 71%
Cmh Detroit Wayne Integrated Health Network $23 - $28 71%
Cmh Genesee County $23 - $28 71%
Cmh Ionia County $23 - $28 71%
Cmh Jackson County/Lifeways $23 - $28 71%
Cmh Kalamazoo $23 - $28 71%
Cmh Kent County $23 - $28 71%
Cmh Lenawee County $23 - $28 71%
Cmh Livingston County $23 - $28 71%
Cmh Macomb $23 - $28 71%
Cmh Misc $23 - $28 71%
Cmh Monroe County $23 - $28 71%
Cmh Montcalm County $23 - $28 71%
Cmh Muskegon County $23 - $28 71%
Cmh Newaygo County $23 - $28 71%
Cmh North Country $23 - $28 71%
Cmh Northern Lakes County $23 - $28 71%
Cmh Oakland County $23 - $28 71%
Cmh Ottawa County $23 - $28 71%
Cmh Van Buren County $23 - $28 71%
Cmh Washtenaw County $23 - $28 71%
Cmh Wayne County/Carelink $23 - $28 71%
Cmh Wayne Cty/Com Liv Svcs $23 - $28 71%
Cmh West Mi County $23 - $28 71%
Community Benefit Health $23 - $28 71%
Community Care Behavorial Health $23 - $28 71%
Community Care Partners $23 - $28 71%
Community Health Choice $23 - $28 71%
Connections Csp $23 - $28 71%
County Coroner $23 - $28 71%
County Funding Generic $23 - $28 71%
Covid19 Hrsa Uninsured Testing And Treatment Fund $23 - $28 71%
Dean Wi Badgercare $23 - $28 71%
Delaware County Department Of Health $23 - $28 71%
Delaware First Health $23 - $28 71%
Delta Dental Nj $23 - $28 71%
Dph Tb Program $23 - $28 71%
Dscc $23 - $28 71%
Eastpointe Lme $23 - $28 71%
Family Health Network $23 - $28 71%
Freedom First Healthcare $23 - $28 71%
Fresno County Ccs $23 - $28 71%
Ghc Scw Wi Badgercare $23 - $28 71%
Harbor Health $23 - $28 71%
Health Safety Net $23 - $28 71%
Healthy Blue Ne $23 - $28 71%
Hennepin Health $23 - $28 71%
Humana $23 - $49 71%
Id County Ada $23 - $28 71%
Id County Canyon $23 - $28 71%
Id County Cat Fund $23 - $28 71%
Id County Other $23 - $28 71%
Id County Payette $23 - $28 71%
Idaho Dept Health And Wellfare $23 - $28 71%
Idaho Womens Health Check $23 - $28 71%
Indiana Breast Cervical Cancer $23 - $28 71%
Inland Empire Health Plan $23 - $28 71%
Intercommunity Health Ohp $23 - $28 71%
Jai Medical System $23 - $28 71%
Kern Family Health Plan $23 - $28 71%
Keystone First $23 - $28 71%
Keystone First Chip $23 - $28 71%
La Care Health Plan $23 - $28 71%
Lakeland Care Inc $23 - $28 71%
Managed Health Services - Indiana $23 - $28 71%
Maryland Breast & Cervical Program $23 - $28 71%
Maryland Healthy Smiles - Scion Dental $23 - $28 71%
Maryland Physicians Care $23 - $28 71%
Massachusetts Behavioral Health Partnership $23 - $28 71%
Mdwise $23 - $28 71%
Medi-Cal $23 - $28 71%
Medi-Cal Healthnet $23 - $28 71%
Medstar Dc Healthy Family $23 - $28 71%
Medstar Md Health Choice $23 - $28 71%
Mo Home State Health Plan $23 - $28 71%
Molina Centennial Care $23 - $28 71%
Nascentia Health Options $23 - $28 71%
New York Cancer Services Program $23 - $28 71%
Nextlevel Health $23 - $28 71%
Oregon Screenwise $23 - $28 71%
Pace Of Southwest Michigan $23 - $30 71%
Paramount Advantage $23 - $28 71%
Parkland Community Health Plan $23 - $28 71%
Partners Behavioral Lme $23 - $28 71%
Peach State Healthplan $23 - $28 71%
Philadelphia County Funding $23 - $28 71%
Presbyterian Centennial Care $23 - $28 71%
Prestige Health Choice $23 - $28 71%
Priority Partners $23 - $28 71%
Robert F Sing Program $23 - $28 71%
Rx 340B Pass Along $23 - $28 71%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $23 - $28 71%
Rx Medi-Cal $23 - $28 71%
Rx Meridian Rx $23 - $28 71%
Ryan White Florida Mssrp $23 - $28 71%
Sandhills Center Lme $23 - $28 71%
Screening For Life $23 - $28 71%
St Joseph County Hlth Dpt $23 - $28 71%
Sunshine State Health Plan $23 - $28 71%
Superior Health $23 - $28 71%
Tenncare $23 - $28 71%
Texas Children'S Health Plan $23 - $28 71%
Trillium Community Ohp $23 - $28 71%
Tufts Health Public Plans $23 - $28 71%
UnitedHealthcare $23 - $211 71%
Vaya Health Lme $23 - $28 71%
Washtenaw Health Plan $23 - $28 71%
Wellsense Health Plan $23 - $28 71%
Wi Womens Wellness $23 - $28 71%
Iowa Total Care $24 - $29 74%
Wellpoint $24 - $29 74%
Align Senior Care $26 - $30 80%
Ally Align Care Adv $26 - $30 80%
American Health Advantage Of Idaho $26 - $30 80%
Aurora Special Needs $26 - $30 80%
Blue Care Network Advantage $26 - $30 80%
Blue Shield - De (Highmark) Medciare Advantage $26 - $30 80%
Care Dimensions $26 - $30 80%
Care Improvement Plus $26 - $30 80%
Care Resources Pace $26 - $30 80%
Careplus Health Plans $26 - $30 80%
Cca - Zing Health $26 - $30 80%
Cca Senior Care Options $26 - $30 80%
Central Valley Medical Services Corp Pace $26 - $30 80%
Champion Health Plan Mcr Advantage $26 - $30 80%
Champva $26 - $30 80%
Clear Spring Health $26 - $30 80%
Clover Health $26 - $30 80%
Commonwealth Care Alliance $26 - $30 80%
Community Pace At Home $26 - $30 80%
Eddy Senior Care-Pace $26 - $30 80%
Eddy Seniorcare Pace $26 - $30 80%
Elementcare $26 - $30 80%
Evercare $26 - $30 80%
Everence $26 - $30 80%
Gateway Health Plan $26 - $30 80%
Genesys Pace Of Genesee County $26 - $30 80%
Georgia Health Advantage $26 - $30 80%
Gold Advantage $26 - $30 80%
Gpa Croell Redi Mix $26 - $30 80%
Health America Advantra $26 - $30 80%
Highmark Health Options Dual Plan $26 - $30 80%
Hope Select Pace $26 - $30 80%
Horizon Nj Total Care $26 - $30 80%
Hudson Headwaters Pace $26 - $30 80%
Huron Valley Pace $26 - $30 80%
Innovative Integrated Health Community Plans $26 - $30 80%
Johns Hopkins Advantage Md $26 - $30 80%
Lasso Healthcare Msa $26 - $30 80%
Life St Marys Pace $26 - $30 80%
Lifecircles Pace $26 - $30 80%
Longevity Health Plan $26 - $30 80%
Longevity Ipa Of Michigan Llc Health Plan Isnp $26 - $30 80%
Martins Point Generations Advantage $26 - $30 80%
Mass General Brigham Mcr Adv $26 - $30 80%
Medicare (plans) $26 - $33 80%
Medipak Advantage $26 - $30 80%
Mercy Life $26 - $30 80%
Mercyone Cedar Valley $26 - $30 80%
Meridian Complete $26 - $30 80%
Michigan Complete Health $26 - $30 80%
Nascentia Health Plus $26 - $30 80%
New Centry Health Careplus $26 - $30 80%
Osu Prime Care Advantage $26 - $30 80%
Pace Cny $26 - $30 80%
Pace Iowa Immanuel Pathways $26 - $30 80%
Pace Southeast $26 - $30 80%
Pace-Trinity Health $26 - $30 80%
Peak Pace Solutions $26 - $30 80%
Perennial Advantage $26 - $30 80%
Preferred Care Partners $26 - $30 80%
Presbyterian Senior Plan $26 - $30 80%
Provider Partners Health Plan Of Illinois $26 - $30 80%
Provider Partners Health Plan Of Indiana $26 - $30 80%
Pruitthealth Premier $26 - $30 80%
Reliance Community Care Partners Care Resources Pace $26 - $30 80%
Rx Allwin $26 - $30 80%
Rx Grane Grnmedd $26 - $30 80%
Rx Retiree Rx Care $26 - $30 80%
Scan Health Plan Mcr Ipa Meritage Oon $26 - $30 80%
Secure Horizons Ma Pffs $26 - $30 80%
Serenity Pace $26 - $30 80%
Siouxland Pace $26 - $30 80%
Solis Health Plans $26 - $30 80%
Sunnyview-Pace Finance Dept $26 - $30 80%
Texan Plus $26 - $30 80%
The Health Plan $26 - $30 80%
Thome Pace $26 - $30 80%
Todays Options $26 - $30 80%
Tribute Health Plans $26 - $30 80%
Tricare $26 - $30 80%
Triwest Health Alliance $26 - $30 80%
Um Health Advantage $26 - $30 80%
Union Health Service $26 - $30 80%
Us Family Health Plan $26 - $30 80%
Veterans Administration $26 - $31 80%
Veterans Eval Services $26 - $30 80%
Welbe Health $26 - $30 80%
Wellmed $26 - $30 80%
American Health Plan $27 - $32 83%
Iowa Health Advantage $27 - $32 83%
Geha $29 - $189 90%
Newton Correctional Facility $29 - $43 90%
Wc Corvel $29 90%
Health Choices $32 - $56 99%
Medical Associates $32 - $45 99%
Amps $33 - $42 102%
Stephenson Cty Health $33 102%
Amish Hospital Aid $35 - $41 108%
Oscar $35 - $44 108%
Wc Praxis Health Network $38 - $56 117%
Wc Reny Company $39 - $57 120%
Wc Velocity $39 - $57 120%
Auto Velocity $40 - $59 123%
Health Smart $40 - $59 123%
Wc O'Hara Corp $40 - $59 123%
Avera $41 - $45 127%
Bcn Domestic $41 - $45 127%
Blue Benefit Administrators Of Massachusetts $41 - $45 127%
Blue Care Network $41 - $45 127%
Blue Distinction Transplant $41 - $45 127%
Blue Shield - Ca $41 - $45 127%
Blue Shield - Id (Regence) $41 - $45 127%
Blue Shield - Ny Highmark Northeastern $41 - $45 127%
Blue Shield - Ny Highmark Western $41 - $45 127%
Blue Shield - Pa (Highmark) $41 - $45 127%
Blue Shield - Wa (Regence) $41 - $45 127%
Kaiser Domestic $41 - $45 127%
Pre-Employment $41 - $45 127%
Wc Domestic $41 - $45 127%
Centivo $44 - $45 136%
Sanford Health Plan $44 - $45 136%
Allied Benefit Systems $45 - $56 139%
Andrie Inc $45 - $66 139%
Auxiant $45 - $104 139%
Claimdoc $45 - $62 139%
East Greenbush Central School District $45 - $66 139%
First Choice Health $45 - $56 139%
Genex Wc $45 - $66 139%
Global Excel $45 - $59 139%
Group Administrators $45 - $56 139%
Health Partners $45 - $102 139%
Healthsmart Workers Comp $45 - $66 139%
Iowa Dept Of Public Health $45 - $160 139%
Jag Source $45 - $66 139%
Lucent Health $45 - $56 139%
Meritain $45 - $59 139%
Midlands $45 - $104 139%
Midlands Choice $45 - $104 139%
Multiplan $45 - $66 139%
Nebraska Total Care $45 - $66 139%
New York State Insurance Fund $45 - $66 139%
Njm Insurance Group $45 - $66 139%
Preferred One $45 - $56 139%
Quiktrip $45 - $51 139%
Rx Heatlhcomp $45 - $66 139%
Rx Restat $45 - $66 139%
Rx Saif Opdp Wc $45 - $66 139%
Rx Worker'S Comp $45 - $66 139%
The Alliance $45 - $55 139%
Ucare $45 - $49 139%
Usa Managed Care $45 - $136 139%
Velocity $45 - $61 139%
Wc Accident Fund $45 - $66 139%
Wc Ace $45 - $66 139%
Wc Acs Federal Employees $45 - $66 139%
Wc Acuity $45 - $66 139%
Wc Advantage $45 - $66 139%
Wc Aegis $45 - $66 139%
Wc Aig $45 - $66 139%
Wc Aims $45 - $66 139%
Wc Alaska National Ins $45 - $66 139%
Wc Align Network $45 - $66 139%
Wc Allied $45 - $66 139%
Wc Am Trust N America $45 - $66 139%
Wc American Claims Mgmt $45 - $66 139%
Wc Amerisure $45 - $66 139%
Wc Amtrust $45 - $66 139%
Wc Asu Risk Mgt $45 - $66 139%
Wc Benetech $45 - $66 139%
Wc Berkley Admin $45 - $66 139%
Wc Broadspire $45 - $66 139%
Wc Broward County $45 - $66 139%
Wc Bunch & Associates $45 - $66 139%
Wc California State Comp Ins $45 - $66 139%
Wc California State Ins Fund $45 - $66 139%
Wc Capitol Area Health Consortium $45 - $66 139%
Wc Ccmsi $45 - $66 139%
Wc Chartis $45 - $66 139%
Wc Chubb $45 - $66 139%
Wc Cirma $45 - $66 139%
Wc City Of Albany $45 - $66 139%
Wc City Of Sioux City $45 - $66 139%
Wc Claims Mgmt Inc $45 - $66 139%
Wc Cna $45 - $66 139%
Wc Comp One Admin C/O Manageability $45 - $66 139%
Wc Compone Admin $45 - $66 139%
Wc Ct Healthcare Trust $45 - $66 139%
Wc Donegal Insurance Group $45 - $66 139%
Wc Emc Insurance Company $45 - $66 139%
Wc Employee Mutual $45 - $66 139%
Wc Enablecomp $45 - $66 139%
Wc Encore Health Network $45 - $66 139%
Wc Erie $45 - $66 139%
Wc Esis $45 - $66 139%
Wc Evolutions $45 - $66 139%
Wc Fcci $45 - $66 139%
Wc Fed Ex $45 - $66 139%
Wc Federal Black Lung $45 - $66 139%
Wc Federated $45 - $66 139%
Wc Finley Occupational Health $45 - $66 139%
Wc First Agency/Occunet $45 - $66 139%
Wc Ford Motor $45 - $66 139%
Wc Fresno Unified Emp $45 - $66 139%
Wc Gallagher Bassett $45 - $66 139%
Wc General Motors $45 - $66 139%
Wc Generic $45 - $66 139%
Wc Genex Care For Ohio $45 - $66 139%
Wc Great West Casualty $45 - $66 139%
Wc Guarantee Insurance $45 - $66 139%
Wc Guard Insurance Company $45 - $66 139%
Wc Hab $45 - $66 139%
Wc Hartford $45 - $66 139%
Wc Hastings $45 - $66 139%
Wc Health Management $45 - $66 139%
Wc Heritage Summit $45 - $66 139%
Wc Hireright $45 - $66 139%
Wc Horizon $45 - $66 139%
Wc Icw Group $45 - $66 139%
Wc Idaho State Ins Fund $45 - $66 139%
Wc Intercare Insurance $45 - $66 139%
Wc Intermountain $45 - $66 139%
Wc Johns Eastern $45 - $66 139%
Wc Kemberton $45 - $66 139%
Wc Key Ins & Benefit Solutions $45 - $66 139%
Wc Liberty Mutual $45 - $66 139%
Wc Mac Risk Management $45 - $66 139%
Wc Massachusetts $45 - $66 139%
Wc Mdia $45 - $66 139%
Wc Meadowbrook Claim $45 - $66 139%
Wc Medical Administrators $45 - $66 139%
Wc Meijers $45 - $66 139%
Wc Memic $45 - $66 139%
Wc Mercy Workcare $45 - $66 139%
Wc Michigan $45 - $66 139%
Wc Michigan Millers Mutual $45 - $66 139%
Wc Mitchell Frankenmuth $45 - $66 139%
Wc Mra $45 - $66 139%
Wc Nationwide $45 - $66 139%
Wc Nca Comp $45 - $66 139%
Wc New York $45 - $66 139%
Wc New York Special Funds $45 - $66 139%
Wc North American Rishces $45 - $66 139%
Wc Northeast Health $45 - $66 139%
Wc Notre Dame $45 - $66 139%
Wc Novanet $45 - $66 139%
Wc Occ Health Allen $45 - $66 139%
Wc Ohio Bureau $45 - $66 139%
Wc One Call Medical $45 - $66 139%
Wc Paradigm $45 - $66 139%
Wc Peerless $45 - $66 139%
Wc Pma $45 - $66 139%
Wc Price Chopper $45 - $66 139%
Wc Procura Management $45 - $66 139%
Wc Qualcare $45 - $66 139%
Wc Quiktrip $45 - $66 139%
Wc Rev Claims $45 - $66 139%
Wc Risico $45 - $66 139%
Wc Rural Mutual $45 - $66 139%
Wc Saif Oregon $45 - $66 139%
Wc Secura $45 - $66 139%
Wc Sedgwick $45 - $66 139%
Wc Sentry $45 - $66 139%
Wc Sheakley Unicomp $45 - $66 139%
Wc Smile Lodge $45 - $66 139%
Wc Society $45 - $66 139%
Wc Srs $45 - $66 139%
Wc Taconic (Mro) $45 - $66 139%
Wc Taconic Farms $45 - $66 139%
Wc Travelers $45 - $66 139%
Wc Triad Group $45 - $66 139%
Wc Tristar $45 - $66 139%
Wc Troy Ny $45 - $66 139%
Wc Tyson $45 - $66 139%
Wc Unified Health Services $45 - $66 139%
Wc United Heartland $45 - $66 139%
Wc Us Dept Of Labor $45 - $66 139%
Wc Walmart $45 - $66 139%
Wc West Bend $45 - $66 139%
Wc West Bend Mutual/Argent $45 - $66 139%
Wc Winnebago Industries $45 - $66 139%
Wc Yankee Trails $45 - $66 139%
Wc York Risk $45 - $66 139%
Wc Zenith $45 - $66 139%
Wc Zurich $45 - $66 139%
1199 National Benefit Fund $56 173%
Asr Health Benefits $56 173%
Christian Brother Services $56 173%
Coventry $56 173%
First Health $56 173%
Luminare Health $56 173%
Medical Mutual $56 173%
Trustmark Small Business Benefits $56 173%
Webtpa $56 173%
Nova $62 191%
Medica $104 321%
Crime Victim Assistance $160 494%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals