CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Alexian Brothers Medical Center 1

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $38
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Alexian Brothers Medical Center 1 is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.17x the Medicare baseline. Located in 800 Biesterfield Rd, Elk Grove Village, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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%)
Insurance Median: $38 (117%)
Ins. Median: $38 (117% 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
Aarp $31 96%
UnitedHealthcare $31 - $33 96%
Aetna $33 - $93 102%
Blue Cross Blue Shield $33 - $90 102%
Cigna $33 - $149 102%
Covid-19 Uninsured $33 102%
Humana $33 102%
Medicare (plans) $33 - $34 102%
Molina Healthcare Of Illinois $34 105%
Bright Health $41 127%
Smarthealth $46 142%
Actin Care $51 157%
Ambetter / Centene $53 164%
County Care $93 287%
Family Health Plan $93 287%
Harmony Health Plan $93 287%
Illinicare $93 287%
Medicaid / KanCare $93 287%
Meridian $93 287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Biesterfield Rd, Elk Grove Village, IL 60007
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals