Occupational therapy (self-care training)
Facility: Munson Healthcare Manistee Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $50
- Cash Discount Price: $236
- vs. Medicare Baseline: 1.54x 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 - $139 | 49% |
| Mclaren Health Plan | $16 - $208 | 49% |
| Meridian | $16 | 49% |
| Molina | $16 - $33 | 49% |
| Priority Health | $16 - $85 | 49% |
| UnitedHealthcare | $16 - $250 | 49% |
| Aetna | $27 - $240 | 83% |
| Cofinity | $27 - $245 | 83% |
| Hap (Health Alliance Plan) | $31 - $222 | 96% |
| Humana | $31 | 96% |
| Medicare (plans) | $31 | 96% |
| Michigan Amish Medical Board | $31 | 96% |
| Northern Michigan Mennonite Group | $31 | 96% |
| Prime Health Services | $31 - $256 | 96% |
| Wellcare Meridian | $31 | 96% |
| Provider Network Of America | $43 - $236 | 133% |
| Asr/Physicians Care | $46 - $222 | 142% |
| Nomi Health | $50 - $222 | 154% |
| Cigna | $51 - $85 | 157% |
| Employee Benefits Logistics | $53 | 164% |
| Hospice Of Michigan | $167 | 515% |
| Munson Hospice | $195 - $852 | 602% |
| Enterprise Group Planning/Employee Benefits Plan | $222 | 685% |
| Medical Cost Savings Solution | $222 | 685% |
| Three Rivers Provider Network | $236 | 728% |
| Multiplan | $245 | 756% |
| Great West Healthcare | $250 | 772% |