Occupational therapy (self-care training)
Facility: Stillwater Billings Clinic
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $119
- Cash Discount Price: $125
- vs. Medicare Baseline: 3.67x 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 367% of the Medicare baseline (a markup of 267%). 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 |
|---|---|---|
| Pacific Source Mcr Advantage | $85 | 262% |
| Tricare | $85 | 262% |
| Blue Cross Blue Shield | $86 - $125 | 265% |
| Humana | $86 | 265% |
| Pacific Steel Direct - All Plans | $88 | 272% |
| Pacific Source Billings Clinic | $94 | 290% |
| Allied Core Value | $109 | 336% |
| Rci Wyoben | $112 | 346% |
| Wyo-Ben Inc- All Plans | $112 | 346% |
| Mountain Health Coop - All Plans | $115 | 355% |
| All Savers-All Plans | $119 | 367% |
| Allegiance Direct Ppo - All Other Plans | $119 | 367% |
| Blackhawk - All Plans | $119 | 367% |
| Cigna | $119 | 367% |
| Ebms Interwest | $119 | 367% |
| Ebms Town Pump | $119 | 367% |
| Gpa Interwest- All Plans | $119 | 367% |
| Interwest Health-All Plans | $119 | 367% |
| Mtada- All Plans | $119 | 367% |
| Pacific Source Voyager - All Other Plans | $119 | 367% |
| Pacificsource Nav | $119 | 367% |
| Prodegi (Y-Tex Corp)- All Plans | $119 | 367% |
| Rci Interwest | $119 | 367% |
| Town Pump Inc- All Plans | $119 | 367% |
| UnitedHealthcare | $119 | 367% |
| Aetna | $121 | 373% |
| Boon Chapman First Choice Health | $121 | 373% |
| Ebms First Choice Health | $121 | 373% |
| First Choice- All Plans | $121 | 373% |
| Murdoch Oil - All Plans | $121 | 373% |
| Rci First Choice Health - All Other Plans | $121 | 373% |
| Ryegate Public Schools - All Plans | $121 | 373% |
| Savatree - All Plans | $121 | 373% |
| Tabs - All Plans | $121 | 373% |
| Trustmark First Choice Health | $121 | 373% |
| Zenith First Choice Health- All Plans | $121 | 373% |
| Allegiance State Of Mt | $175 | 540% |