Occupational therapy (self-care training)
Facility: Byrd Regional Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $120
- Cash Discount Price: $128
- vs. Medicare Baseline: 3.70x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 370% of the Medicare baseline (a markup of 270%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $26 - $845 | 80% |
| Coventry Healthcare Of La | $26 - $504 | 80% |
| Amerihealth Caritas | $27 - $120 | 83% |
| Correct Care Int Hth | $27 - $120 | 83% |
| Healthy Blue | $27 - $120 | 83% |
| La Healthcare Conn Mdcaid | $27 - $120 | 83% |
| Medicaid / KanCare | $27 - $120 | 83% |
| UnitedHealthcare | $27 - $845 | 83% |
| Champva | $28 | 86% |
| Christus Health Plan | $28 | 86% |
| Tricare | $28 - $32 | 86% |
| Humana | $30 - $132 | 93% |
| Blue Advantage | $31 - $32 | 96% |
| Freedom Beh Hospital | $31 - $32 | 96% |
| Industrial | $31 - $845 | 96% |
| Mcr Devoted Healthcare | $31 - $32 | 96% |
| Mcr Lagniappe | $31 - $32 | 96% |
| Medicare (plans) | $31 - $32 | 96% |
| Mutual Of Omaha | $31 - $845 | 96% |
| Peoples Health Mcr Adv | $31 - $32 | 96% |
| Vantage Health Plan | $31 - $32 | 96% |
| Veterans Administration | $31 - $32 | 96% |
| Ambetter / Centene | $32 - $38 | 99% |
| Gulf South Risk Services | $32 - $40 | 99% |
| Blue Cross Blue Shield | $57 | 176% |
| Self Pay | $63 - $254 | 194% |
| Workers Comp | $88 - $760 | 272% |
| Cigna | $125 - $537 | 386% |
| Verity Health | $148 - $592 | 457% |
| Us Dept Of Labor | $190 - $760 | 586% |
| Aflac | $211 - $845 | 651% |
| American Health Advantage | $211 - $845 | 651% |
| Amfirst | $211 - $845 | 651% |
| Hospice Of Leesville | $211 - $845 | 651% |
| Misc Comm | $211 - $845 | 651% |
| Mischmoppo | $211 - $845 | 651% |
| Mva | $211 - $845 | 651% |
| Phcs Private Health | $211 - $845 | 651% |
| Physicans Mutual | $211 - $845 | 651% |
| State Farm Insurance | $211 - $845 | 651% |
| Sterling | $211 - $845 | 651% |
| Stonetrust | $211 - $845 | 651% |
| Tri Parish Rehab | $211 - $845 | 651% |
| United Teacher Asso | $211 - $845 | 651% |
| Web Tpa | $211 - $845 | 651% |