Occupational therapy (self-care training)
Facility: Boone County Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $57
- Cash Discount Price: $96
- vs. Medicare Baseline: 1.76x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $31 | 96% |
| Amerigroup Mcr Adv - All Other Plans | $47 - $52 | 145% |
| Choice Care Mcr Adv - All Plans | $47 - $52 | 145% |
| Humana | $47 - $113 | 145% |
| Iowa Hlth Adv - All Plans | $47 - $52 | 145% |
| Mt Carmel Hp - All Plans | $47 - $52 | 145% |
| UnitedHealthcare | $47 - $74 | 145% |
| Va Ccn-All Plans | $47 - $52 | 145% |
| Aetna | $48 - $60 | 148% |
| Meridian Mcaid - All Plans | $51 - $57 | 157% |
| Iowa Total Care Mcaid - All Plans | $52 - $58 | 160% |
| Medicaid / KanCare | $53 - $58 | 164% |
| Healthsmart Accell Network | $80 - $88 | 247% |
| Medical Associates Hp-All Plans | $86 - $95 | 265% |
| Wellmark Hmo | $88 | 272% |
| Healthsmart Ppo - All Other Plans | $91 - $101 | 281% |
| Wellmark Ppo - All Other Plans | $97 | 299% |
| Health Alliance-All Plans | $103 - $113 | 318% |
| Midlands Choice-All Plans | $105 - $116 | 324% |
| Mutually Preferred-All Plans | $108 - $120 | 333% |