CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Mc Donough District Hospital

Billing Code: 97535 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$31
about 1.0× the $32 Medicare rate · typically $27–$34
modeled estimate · not a bill or quote
What this hospital charges insurers
$31
About the fair price
1.0× Medicare
Medicare pays $32 Fair price $31 This hospital $31

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

A typical price — 0 charge more and 3 charge less, among the 9 IL hospitals compared.

Cheapest $22 Priciest $31

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Occupational therapy (self-care training) is about $31 (about 1.0× the $32 Medicare rate). Mc Donough District Hospital charges insurers about $31 — about the fair price. Located in Macomb, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $29 - $31 90%
Blue Cross Blue Shieldmajor $38 117%
Aetnamajor $31 - $38 96%
Humanamajor $31 - $38 96%
Meridian $31 96%
Molina $31 96%
+ 3 smaller / regional plans $18 - $31
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals