CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Rapides Regional Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $32
Cash Discount Price: $625
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Rapides Regional Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 0.99x the Medicare baseline. Located in 211 4Th Street, Alexandria, LA.

Cash / Self-Pay

$625

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $625 (1929%)

Insurance Median: $32 (99%)

Cash: $625 (1929% of Medicare)

Ins. Median: $32 (99% 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
Triwest Healthcare Alliance	$26 - $30	80%
Aetna	$27 - $208	83%
Blue Cross Blue Shield	$27 - $71	83%
Devoted Health	$27 - $30	83%
Humana	$27 - $214	83%
United	$27 - $145	83%
United Va Ccn	$27 - $30	83%
Vantage Health Plan	$27 - $80	83%
Dignity Care Corporation	$28 - $31	86%
Wellcare	$28 - $32	86%
Medical Development International	$31 - $35	96%
Universal Healthcare	$32 - $37	99%
Allegiance Health Management	$48 - $55	148%
Verity	$181 - $195	559%
Cigna	$188 - $203	580%
Ppo Plus	$229 - $247	707%
Louisiana Workers Compensation Corporation	$295 - $318	910%
Gilsbar 360	$319 - $344	985%
Multiplan	$326 - $377	1006%
Dma Regional Ppo	$421 - $454	1299%
Employers Health Network	$421 - $454	1299%
First Health	$421 - $454	1299%
Healthsouth Corporation	$421 - $454	1299%
Plan Vista Solutions (Nppn)	$469 - $506	1448%
Bestcomp	$487 - $526	1503%

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 $625.
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 Rapides Regional Medical Center 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.