CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Our Lady of the Lake Surgical Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $61
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Our Lady of the Lake Surgical Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.88x the Medicare baseline. Located in 1700 W Lindberg Drive, Slidell, LA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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%)

Insurance Median: $61 (188%)

Ins. Median: $61 (188% 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
Aetna	$15 - $38	46%
Amerihealth Caritas	$18 - $38	56%
Louisiana Healthcare Connection	$18 - $38	56%
UnitedHealthcare	$18 - $252	56%
Blue Cross Blue Shield	$27 - $34	83%
Gilsbar 360	$59 - $126	182%
Humana	$59 - $126	182%
Hs Technology	$77 - $164	238%
First Health	$80 - $171	247%
Womans Hospital Employees	$83 - $176	256%
Medical Cost Containment Professionals	$106 - $227	327%
Peoples Health	$106 - $227	327%
Usa Managed Care Organization	$111 - $237	343%
Three Rivers Provider Network	$112 - $239	346%
Cigna	$150	463%

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 $X.
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 Our Lady of the Lake Surgical 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.