CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Sunrise Hospital and Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $33
  • Cash Discount Price: $194
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Sunrise Hospital and Medical Center is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.02x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.
Cash / Self-Pay
$194

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: $194 (599%)
Insurance Median: $33 (102%)
Cash: $194 (599% 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
Aetna $4 - $61 12%
Culinary Health Fund $19 - $48 59%
Humana $21 - $33 65%
Amerigroup $23 - $31 71%
Health Plan Nevada $23 - $32 71%
Molina $24 - $34 74%
Silver Summit $24 - $40 74%
Cigna $27 - $28 83%
Select Health $27 - $107 83%
Alignment Health Plan $28 - $33 86%
Ambetter / Centene $28 - $98 86%
Blue Cross Blue Shield $28 - $64 86%
Caremore $28 - $34 86%
Hometown Health Mcr $28 - $33 86%
Triwest Healthcare Alliance $28 - $33 86%
United $28 - $97 86%
Community Care Health $30 - $31 93%
Imperial Nv $30 - $36 93%
Molina Healthcare $30 - $32 93%
Sierra Hpn $30 - $31 93%
Healthcare Partners Of Nv $31 - $42 96%
Caresource $32 99%
Health Net $32 - $33 99%
Universal Healthcare $33 - $39 102%
Hometown Health Providers $37 - $232 114%
Sierra $40 - $43 123%
Multiplan $42 - $339 130%
Legacy Provider Network $87 269%
Corvel $92 - $98 284%
Comp-Med Workers Comp $94 290%
Olympus Medsave Usa $97 - $349 299%
Prominence Healthfirst $139 - $140 429%
Cmn Global $194 - $195 599%
Nv Health & Welfare Trust $278 - $279 858%
First Health $306 - $372 944%
Medcare International $347 - $349 1071%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3186 S Maryland Pkwy, Las Vegas, NV 89109
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals