CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Hutchinson Health

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $44
Cash Discount Price: $102
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Hutchinson Health is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.36x the Medicare baseline. Located in 1095 Highway 15 South, Hutchinson, MN.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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%)

Cash / Self-Pay: $102 (315%)

Insurance Median: $44 (136%)

Cash: $102 (315% of Medicare)

Ins. Median: $44 (136% 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
Medicaid / KanCare	$27 - $132	83%
Ma Wisconsin Replacement [950271]	$30	93%
UnitedHealthcare	$30 - $478	93%
Blue Cross Blue Shield	$32 - $44	99%
Medicare (plans)	$33	102%
Healthpartners [900713]	$132	407%
First Health Network [950334]	$199	614%
Medica [900156]	$379	1170%

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 $102.
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 Hutchinson Health 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.