CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Angel Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $41
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Angel Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.27x the Medicare baseline. Located in 124 Center Court Po Box 1209, Franklin, NC.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $116 (358%)
Insurance Median: $41 (127%)
Cash: $116 (358% of Medicare)
Ins. Median: $41 (127% 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
Blue Cross Blue Shield $19 - $21 59%
Amerigroup $21 65%
Amerihealth $21 - $22 65%
Partners Health Management $21 - $22 65%
United $21 - $53 65%
Vaya Health $21 - $22 65%
Wellcare $21 - $22 65%
Apex Health $23 - $24 71%
Aetna $25 - $76 77%
One Call Medical $33 - $37 102%
Cigna $40 - $68 123%
Amerihealth Caritas $44 - $46 136%
Caresource $50 - $52 154%
Medcost $50 - $63 154%
Magellan $68 - $71 210%
Magellan Behavioral Health $68 - $71 210%
Multiplan $91 - $95 281%
Avalon Administrative Services $97 - $101 299%
Prime Health $100 - $107 309%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 124 Center Court Po Box 1209, Franklin, NC 28734
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals