CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: New London Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $58
Cash Discount Price: $60
vs. Medicare Baseline: 1.79x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at New London Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.79x the Medicare baseline. Located in 273 County Road, New London, NH.

Cash / Self-Pay

$60

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $60 (185%)

Insurance Median: $58 (179%)

Cash: $60 (185% of Medicare)

Ins. Median: $58 (179% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Amerihealth Caritas Nh	$24 - $67	74%
Granite State Health Plan	$24 - $67	74%
Wellsense Health Plan	$24 - $58	74%
Blue Cross Blue Shield	$28 - $109	86%
Martin'S Point Generations Advantage	$33 - $58	102%
Martin'S Point Health Care	$33 - $91	102%
UnitedHealthcare	$33 - $103	102%
Wellcare Health Plans	$34 - $58	105%
Aetna	$37 - $114	114%
Harvard Pilgrim Health Care Of Ne	$38 - $94	117%
Ambetter / Centene	$42 - $58	130%
Cigna	$45 - $89	139%
Tufts Health Plan	$91 - $95	281%
Coventry	$125	386%
Multiplan	$125	386%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $60.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97535.

Insurance In-Network Protection Plan

Contact your insurance company to confirm New London Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97535.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.