CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Henry Ford Allegiance Health

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $63
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.94x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Henry Ford Allegiance Health is $63. 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 1.94x the Medicare baseline. Located in 205 N East Ave, Jackson, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $63 (194%)
Ins. Median: $63 (194% 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.

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
Blue Cross Blue Shield $16 - $51 49%
Hap Caresource $16 49%
Mclaren $16 49%
Meridian Health Plan Of Mi $16 - $45 49%
Priority Health $16 - $63 49%
Aetna $17 - $100 52%
Molina $17 52%
Humana $31 96%
Bcn $41 127%
Molina Mi Health Link $46 142%
Mclaren Health $77 238%
Vitalcore Physicians Group Of Mi $77 238%
Jackson County Offiice Of The Sheriff $80 247%
Immergrun Inc $92 284%
Hap $95 293%
UnitedHealthcare $114 352%
University Of Michigan $120 370%
Cigna $137 423%
Cofinity Group Health $139 429%
Frontpath $139 429%
Multiplan, Inc. $139 429%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 205 N East Ave, Jackson, MI 49201
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals