Occupational therapy (self-care training)
Facility: Bienville Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $576
- Cash Discount Price: $605
- vs. Medicare Baseline: 17.78x 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 1778% of the Medicare baseline (a markup of 1678%). 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 | $11 - $3,450 | 34% |
| Medicaid / KanCare | $11 - $202 | 34% |
| Mmd Amerihealth Caritas | $11 - $202 | 34% |
| Mmd Healthy Blue | $11 - $202 | 34% |
| Mmd La Hlth Conn | $11 - $202 | 34% |
| Mmd Misc | $11 - $202 | 34% |
| UnitedHealthcare | $11 - $1,863 | 34% |
| Cashiering | $73 - $2,070 | 225% |
| Cigna | $92 - $1,725 | 284% |
| Ambetter / Centene | $99 - $1,863 | 306% |
| Humana | $99 - $2,227 | 306% |
| Mcr American Hlth Adv | $99 - $1,863 | 306% |
| Medicare (plans) | $99 - $1,863 | 306% |
| Misc Mgd Care | $99 - $3,450 | 306% |
| Mmc Blue Advantage | $99 - $1,863 | 306% |
| Mmc Misc | $99 - $1,863 | 306% |
| Peoples Health Mcr Adv | $99 - $1,863 | 306% |
| Va Health | $99 - $1,863 | 306% |
| Blue Cross Blue Shield | $110 - $2,077 | 340% |
| Wc City Of Arcadia | $165 - $3,105 | 509% |
| Wc House Of Raeford | $165 - $3,105 | 509% |
| Wc Misc | $165 - $3,105 | 509% |
| Wc Stonetrust | $165 - $3,105 | 509% |
| Aarp | $184 - $3,450 | 568% |
| Allegiance Health Managme | $184 - $3,450 | 568% |
| Amfirst | $184 - $3,450 | 568% |
| Apwu | $184 - $3,450 | 568% |
| Liberty Mutual | $184 - $3,450 | 568% |
| Misc Comm A-L | $184 - $3,450 | 568% |
| Misc Comm M-Z | $184 - $3,450 | 568% |
| Tricare | $184 - $3,450 | 568% |