Occupational therapy (self-care training)
Facility: Deaconess Henderson Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $45
- Cash Discount Price: $61
- vs. Medicare Baseline: 1.39x 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 |
|---|---|---|
| Aetna | $15 - $197 | 46% |
| Humana | $15 - $162 | 46% |
| Medicaid / KanCare | $15 - $41 | 46% |
| UnitedHealthcare | $15 - $130 | 46% |
| Wellcare Ky | $15 - $29 | 46% |
| Blue Cross Blue Shield | $22 - $31 | 68% |
| Wellcare Il | $22 - $29 | 68% |
| Ky Racing Health & Welfare Fund | $26 - $59 | 80% |
| Self-Pay | $26 - $61 | 80% |
| Medicare (plans) | $29 | 90% |
| Mhs Mco | $29 | 90% |
| Molina Healthcare Of Ky | $29 | 90% |
| Molina Healthcare Of Ky - Exchange | $29 | 90% |
| Mytru Advantage | $29 - $59 | 90% |
| Umwa | $29 | 90% |
| Alliance Coal | $31 - $45 | 96% |
| Caresource In | $31 | 96% |
| Caresource In Marketplace | $38 | 117% |
| Wellcare Ky Commercial Exchange | $38 | 117% |
| Center Care Narrow | $40 - $170 | 123% |
| Center Care Open Access | $40 - $170 | 123% |
| Encircle/Encore Combined | $40 - $117 | 123% |
| Encircle/Encore Prime | $40 - $110 | 123% |
| Amish And Mennonite Of Western Ky | $45 - $49 | 139% |
| Cigna | $45 - $130 | 139% |
| Claimdoc | $45 - $122 | 139% |
| Hopetrust | $45 | 139% |
| Hstechnology | $45 - $122 | 139% |
| First Health Network (Coventry) | $47 - $173 | 145% |
| Healthlink | $47 - $152 | 145% |
| Iu Health Plans | $47 - $104 | 145% |
| Noncontracted | $47 | 145% |
| Phcs/Multiplan | $47 - $170 | 145% |
| Sagamore | $47 - $179 | 145% |
| Coventry National Network | $60 - $162 | 185% |
| One Care | $60 | 185% |
| Webster County Detention Center | $60 - $162 | 185% |
| Henderson County Detention Center | $68 - $183 | 210% |