CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Research Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $55
  • Cash Discount Price: $435
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Research Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $435. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.70x the Medicare baseline. Located in 2316 E Meyer Blvd, Kansas City, MO.
Cash / Self-Pay
$435

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $435 (1343%)
Insurance Median: $55 (170%)
Cash: $435 (1343% of Medicare)
Ins. Median: $55 (170% 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
United $19 - $196 59%
Aetna $20 - $222 62%
Amerigroup $20 62%
Healthyblue $20 62%
Medicaid / KanCare $20 62%
Unicare $20 62%
Home State Health Plan $24 74%
Blue Cross Blue Shield $27 - $170 83%
Coventry $27 - $175 83%
UnitedHealthcare $27 - $435 83%
Celtic $28 - $32 86%
Cigna $28 - $218 86%
Devoted Health $28 - $31 86%
Humana $28 - $283 86%
Wellcare $28 - $32 86%
Pyramid Life $30 - $34 93%
Triwest Health Alliance $31 96%
Multiplan $37 - $322 114%
Corvel Corporation $44 - $283 136%
Oha Network $46 - $218 142%
Ambetter / Centene $81 250%
Nhc Advantage $83 256%
Oscar $83 256%
Wppa Providrs Care Network $87 269%
Universal Healthcare $152 469%
Coventry Kc Mo $178 549%
College Park Family Care Center $187 577%
Emerging Therapy Solutions $209 - $218 645%
Focus Healthcare Mgmt, Inc $326 1006%
Cco, Inc. $348 1074%
Evernorth Behavioral Health $348 1074%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2316 E Meyer Blvd, Kansas City, MO 64132
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals