CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Intermountain Health St Vincent Regional Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $62
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.91x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Intermountain Health St Vincent Regional Hospital is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.91x the Medicare baseline. Located in 1233 N 30Th St, Billings, MT.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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%)
Insurance Median: $62 (191%)
Ins. Median: $62 (191% 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
Medicare (plans) $36 111%
UnitedHealthcare $37 - $69 114%
First Choice Health $40 - $67 123%
Other $40 - $67 123%
Exchange Other $45 - $49 139%
Mt Health Co-Op $45 - $49 139%
Ebms-Employee Benefit Mng $46 - $86 142%
Meritain Health $46 - $56 142%
Aetna $48 148%
Allegiance $51 - $99 157%
Cigna $51 - $67 157%
Blue Cross Blue Shield $56 - $101 173%
Preferred One $64 - $70 198%
Interwest $67 207%
Pacificsource $67 - $90 207%
Private Hlthcare Sys $68 210%
Sibanye Stillwater Health Partners $68 210%
Geha $69 213%
Coastal Administrative Services $72 222%
Pacific Steel And Recycling $90 278%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1233 N 30Th St, Billings, MT 59107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals