CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Ochsner Watkins Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $91
Cash Discount Price: $103
vs. Medicare Baseline: 2.81x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Ochsner Watkins Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 2.81x the Medicare baseline. Located in 605 South Archusa Avenue, Quitman, MS.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $103 (318%)

Insurance Median: $91 (281%)

Cash: $103 (318% of Medicare)

Ins. Median: $91 (281% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 281% of the Medicare baseline (a markup of 181%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$40 - $123	123%
Prime Health Services Ppo -Workers Comp	$50	154%
Cor Vel	$51	157%
Humana	$72 - $90	222%
Cigna	$75 - $90	231%
Ambetter / Centene	$90	278%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$90	278%
Medicare (plans)	$90 - $103	278%
UnitedHealthcare	$90 - $110	278%
Shared Health Mississippi	$94	290%
Aetna	$100	309%
Select Administrative Services Network	$108	333%
Claritev D/B/A Multiplan/Phcs/American Life Care	$116	358%
Zelis	$116	358%
Prime Health Services Ppo	$123	380%
Primewell Health Services Commercial Exchange Plan	$127	392%
Primewell Health Services – Commercial	$127	392%

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 $103.
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 Ochsner Watkins Hospital 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.