CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: University of Illinois Hospital and Clinics

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $40
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at University of Illinois Hospital and Clinics is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.23x the Medicare baseline. Located in 1740 West Taylor St Suite 1400, Chicago, IL.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $85 (262%)
Insurance Median: $40 (123%)
Cash: $85 (262% of Medicare)
Ins. Median: $40 (123% 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
Molina $26 - $40 80%
Aetna $27 - $45 83%
Coventry $27 - $33 83%
United $32 - $33 99%
Blue Cross Blue Shield $33 - $49 102%
Health Alliance $33 - $44 102%
Longevity Health Plan $33 102%
Sinai Medical Group $33 102%
UnitedHealthcare $33 102%
Caterpillar $34 105%
Clear Springs Health $34 105%
Humboldt Park Health Partners $34 105%
Physicians Health Association Of Il $34 105%
Resurrection Phys Provider Group $34 105%
Village Md $34 - $41 105%
Wellcare $34 105%
Zing Health $34 105%
Campus Care $35 - $49 108%
Uic Physician Group $36 111%
St Anthony Health Network $39 120%
Union Health Service $39 120%
County Care Health Plan $40 123%
Franciscan Hammond Clinic Llc $40 123%
Meridian $40 123%
Youthcare Healthchoice $40 123%
Dolton Medical Associates $41 127%
Mac Neal Health Providers $41 127%
Mercy Physician Association $41 127%
Physician Care Network Inc $41 127%
Unified Physicians Network $41 127%
West Suburban Health Providers $41 127%
Lake County Physician Associates $43 133%
Northshore Physician Association $43 133%
Northwest Primary Care Alliance $43 133%
Southwest Physician Group Ltd $43 133%
Fox Valey Medicine Ltd $44 136%
Oak West Primary Care Alliance $44 136%
Valenz $44 136%
Healthsmart $49 151%
The Alliance $49 151%
Equian $52 160%
Healthlink $52 - $2,385 160%
Multiplan $52 - $69 160%
Zelis $52 160%
Integrated Health Plan $57 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1740 West Taylor St Suite 1400, Chicago, IL 60612
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals