Occupational therapy (self-care training)
Facility: Bmh-Calhoun
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $108
- Cash Discount Price: $86
- vs. Medicare Baseline: 3.33x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 333% of the Medicare baseline (a markup of 233%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Ppo Holdings | $32 - $82 | 99% |
| Magnolia Regional Health Center | $34 - $86 | 105% |
| Blue Cross Blue Shield | $35 - $95 | 108% |
| Tricare | $35 - $88 | 108% |
| Devoted Health | $37 - $94 | 114% |
| Molina | $37 - $171 | 114% |
| Ms Breast And Cervical | $37 - $92 | 114% |
| Triwest | $37 - $92 | 114% |
| Vaccn | $37 - $92 | 114% |
| Aetna | $38 - $140 | 117% |
| American Health Plan | $38 - $97 | 117% |
| Humana | $38 - $172 | 117% |
| Primewell | $38 - $97 | 117% |
| Shared Health | $38 - $97 | 117% |
| Littler | $42 - $108 | 130% |
| Magnolia Ms | $42 - $105 | 130% |
| Cigna | $47 - $118 | 145% |
| First Choice Health Plan Of Ms | $55 - $139 | 170% |
| Burch Food Services | $62 - $157 | 191% |
| First State Bank Trust | $62 - $157 | 191% |
| Arlington Community Schools | $66 - $166 | 204% |
| Armstrong Relocation | $66 - $166 | 204% |
| Ashley Furniture Stores | $66 - $166 | 204% |
| Bartlett City Schools | $66 - $166 | 204% |
| Brimhall Foods | $66 - $166 | 204% |
| Building Plastic | $66 - $166 | 204% |
| Cannon Motor Company | $66 - $166 | 204% |
| Carlisle | $66 - $166 | 204% |
| City Of Bartlett | $66 - $166 | 204% |
| City Of Lakeland | $66 - $166 | 204% |
| Collierville Schools | $66 - $166 | 204% |
| Crittenden County | $66 - $166 | 204% |
| Davidson Hospitality | $66 - $166 | 204% |
| Delta Industries | $66 - $166 | 204% |
| Desoto Co Board Of Supervisors | $66 - $166 | 204% |
| Dunn Investment Company | $66 - $166 | 204% |
| Eas Mssc Schools | $66 - $166 | 204% |
| First Community Bank | $66 - $166 | 204% |
| French Camp Academy | $66 - $166 | 204% |
| Gossett Motor Cars | $66 - $166 | 204% |
| Hattiesburg Clinic | $66 - $166 | 204% |
| Heartland Catfish Company | $66 - $166 | 204% |
| Heavy Machines | $66 - $166 | 204% |
| Hollowell Industries | $66 - $166 | 204% |
| Hospitality Management Advisors | $66 - $166 | 204% |
| Jas D Collier | $66 - $166 | 204% |
| Lakeland School System | $66 - $166 | 204% |
| Malco Theaters | $66 - $166 | 204% |
| Mechanical Systems | $66 - $166 | 204% |
| Mid-South Transport | $66 - $166 | 204% |
| Minact | $66 - $166 | 204% |
| Patterson Warehouses | $66 - $166 | 204% |
| Radians | $66 - $166 | 204% |
| Rei Nation | $66 - $166 | 204% |
| Retzer Resources | $66 - $166 | 204% |
| Ritchey Automotive | $66 - $166 | 204% |
| Security One | $66 - $166 | 204% |
| Silver Tree | $66 - $166 | 204% |
| State Systems | $66 - $166 | 204% |
| Town Of Collierville | $66 - $166 | 204% |
| United Tn Holdings | $66 - $166 | 204% |
| Vaughn Electric | $66 - $166 | 204% |
| W G Yates | $66 - $166 | 204% |
| W W Wood Products | $66 - $166 | 204% |
| Watkins Uiberall | $66 - $166 | 204% |
| Y K Auto Group | $66 - $166 | 204% |
| Advanced Health Systems Inc. | $68 - $172 | 210% |
| Christian Health Aid | $68 - $172 | 210% |
| Ppo Plus | $72 - $183 | 222% |
| Employers Health Network | $73 - $185 | 225% |
| Harding Academy | $73 - $185 | 225% |
| Multiplan | $76 - $194 | 235% |
| Qca | $76 - $194 | 235% |