CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Carepartners Rehabilitation Hospital, Lllp

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $33
  • Cash Discount Price: $93
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Carepartners Rehabilitation Hospital, Lllp is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.02x the Medicare baseline. Located in 68 Sweeten Creek Rd, Asheville, NC.
Cash / Self-Pay
$93

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $93 (287%)
Insurance Median: $33 (102%)
Cash: $93 (287% of Medicare)
Ins. Median: $33 (102% 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
Apex Health $19 59%
Alignment Health $27 - $31 83%
Devoted Health $27 - $31 83%
United $27 - $56 83%
Aetna $28 - $32 86%
Humana $28 - $32 86%
Wellcare $28 - $57 86%
Provider Partners Health Plan $29 - $33 90%
Cigna $30 - $34 93%
Healthteam Advantage $30 - $34 93%
Troy Healthcare $30 - $34 93%
Amerihealth Caritas $31 - $36 96%
Longevity Health Plan $33 - $37 102%
Blue Cross Blue Shield $54 - $55 167%
Ambetter / Centene $56 173%
Amerihealth $56 - $57 173%
Caresource $56 173%
Medcost $66 204%
Multiplan $76 - $77 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 68 Sweeten Creek Rd, Asheville, NC 28803
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL