CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Harrison County Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $57
Cash Discount Price: $102
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Harrison County Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.76x the Medicare baseline. Located in 245 Atwood Street, Corydon, IN.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $102 (315%)

Insurance Median: $57 (176%)

Cash: $102 (315% of Medicare)

Ins. Median: $57 (176% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Tricare	$22 - $44	68%
Aetna	$24 - $226	74%
Blue Cross Blue Shield	$24 - $226	74%
Caresource Mcaid Hip	$24 - $47	74%
Caresource Mcr Adv	$24 - $47	74%
Humana	$24 - $151	74%
Mdwise Mcaid Hip	$24 - $47	74%
Mhs Exchange-All Other Plans	$24 - $47	74%
Mhs Mcaid Hip	$24 - $47	74%
Mhs Mcr Adv	$24 - $48	74%
Passport Mcaid-All Other Plans	$24 - $47	74%
Passport Mcr Adv	$24 - $47	74%
UnitedHealthcare	$24 - $226	74%
Communicare Adv-All Plans	$25 - $48	77%
Siho Exchange	$25 - $49	77%
Passport Mcaid Beh Hlth	$29 - $56	90%
Caresource Exchange-All Other Plans	$31 - $62	96%
Buckeye Exchange-All Plans	$40 - $78	123%
Siho One Southern	$58 - $113	179%
Encore Encircle	$92 - $181	284%
Sagamore-All Plans	$92 - $181	284%
Siho Ppo/Hmo - All Other Plans	$92 - $181	284%
Beech Street Comm-All Plans	$98 - $192	302%
First Health-All Plans	$98 - $192	302%
Cigna	$104 - $203	321%
Encore Ppo - All Other Plans	$104 - $203	321%
Multiplan-All Plans	$104 - $203	321%
Caresource Mcaid Hhw	$115 - $226	355%
Mdwise Mcaid Hhw/Hcc - All Other Plans	$115 - $226	355%
Mhs Mcaid Hhw/Hcc	$115 - $226	355%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $102.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97535.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Harrison County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97535.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.