Occupational therapy (self-care training)
Facility: Munson Healthcare Cadillac Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $41
- Cash Discount Price: $101
- vs. Medicare Baseline: 1.27x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $16 - $57 | 49% |
| Mclaren Health Plan | $16 - $75 | 49% |
| Meridian | $16 | 49% |
| Molina | $16 - $33 | 49% |
| Priority Health | $16 - $85 | 49% |
| UnitedHealthcare | $16 - $74 | 49% |
| Aetna | $27 - $90 | 83% |
| Cofinity | $27 - $93 | 83% |
| American Health Associates | $31 | 96% |
| Autumnwood Of Mcbain Skilled Nursing | $31 | 96% |
| Blue Care Network | $31 | 96% |
| Hap (Health Alliance Plan) | $31 - $95 | 96% |
| Humana | $31 | 96% |
| Medicare (plans) | $31 | 96% |
| Michigan Amish Medical Board | $31 | 96% |
| Promedica | $31 | 96% |
| Samaritas Senior Living Skilled Nursing | $31 | 96% |
| Wellcare (Meridian) | $31 | 96% |
| Provider Network Of America Group Health | $43 - $101 | 133% |
| Asr/Physicians Care | $46 - $95 | 142% |
| Cigna | $51 - $85 | 157% |
| Employee Benefits Logistics | $53 | 164% |
| Hospice Of Michigan | $71 | 219% |
| Munson Hospice | $83 - $852 | 256% |
| Enterprise Group Planning/Employee Benefit Plan | $95 | 293% |
| Medical Cost Savings Solution | $95 | 293% |
| Nomi Health | $95 | 293% |
| Robbing Group And Regency Employee Benefits | $95 | 293% |
| First Health/Coventry Network | $101 | 312% |
| Three Rivers Provider Network | $101 | 312% |