CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Poplar Bluff Regional Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $48
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Poplar Bluff Regional Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.48x the Medicare baseline. Located in 3100 Oak Grove Road, Poplar Bluff, MO.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $50 (154%)
Insurance Median: $48 (148%)
Cash: $50 (154% of Medicare)
Ins. Median: $48 (148% 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
Medicaid / KanCare $28 - $48 86%
Blue Access $30 93%
Blue Cross Blue Shield $30 - $51 93%
Humana $30 93%
Medicare (plans) $30 93%
Node Champva $30 93%
Node Hospice Non Par Agree $30 93%
Node United Behavioral Health Mcr Adv $30 93%
Node Va $30 93%
Tricare $30 93%
UnitedHealthcare $30 - $106 93%
Veterans Eval Services $30 93%
Node Ahs Mcr Adv $31 96%
Node Devoted Health Mcr Adv $31 96%
Node Pphp Mcr Adv $34 105%
Centurion Correctional $38 117%
Self Pay $47 145%
Us Department Of Labor $47 145%
Naphcare $57 176%
Home State Exchange $75 231%
W W Wood $75 231%
Cigna $107 - $157 330%
Evolutions Healthcare $107 330%
Tyson Foods $108 333%
Access Health Services, Llc $112 346%
Parker Hannifin $118 - $138 364%
Healthlink $123 380%
First Health $128 395%
Blue Traditional $145 - $152 448%
Coventry Wc $157 485%
Municipal Health $157 485%
Multiplan $171 528%
Phcs $171 528%
Compresults Wc $177 546%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Oak Grove Road, Poplar Bluff, MO 63901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals