CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Frankfort Regional Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $31
  • Cash Discount Price: $397
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Frankfort Regional Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $397. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 0.96x the Medicare baseline. Located in 299 Kings Daughters Drive, Frankfort, KY.
Cash / Self-Pay
$397

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $397 (1225%)
Insurance Median: $31 (96%)
Cash: $397 (1225% of Medicare)
Ins. Median: $31 (96% 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
Aetna $27 - $30 83%
Blue Cross Blue Shield $27 - $110 83%
Devoted Health $27 - $30 83%
Humana $27 - $110 83%
United $27 - $179 83%
United Behavioral Health $27 - $30 83%
United Va $27 - $30 83%
Wellcare $27 - $35 83%
Horizon Pace $28 - $31 86%
Molina $32 99%
Corvel $64 198%
Prime Health $64 198%
Coventry Cares $71 219%
Signature Advantage $75 231%
Cigna $117 361%
Essence Healthcare $179 552%
Baptist Health Network $214 660%
Hospice Of Central Kentucky $250 772%
Occupational Mc Alliance $317 978%
Multiplan $377 1164%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 299 Kings Daughters Drive, Frankfort, KY 40601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals