Occupational therapy (self-care training)
Facility: University Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $131
- Cash Discount Price: $104
- vs. Medicare Baseline: 4.04x 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 404% of the Medicare baseline (a markup of 304%). 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 |
|---|---|---|
| Aig | $19 - $163 | 59% |
| Beech Street | $19 - $163 | 59% |
| Cement Masons & Plasters H&W | $19 - $147 | 59% |
| Cigna | $27 - $84 | 83% |
| Cirque De Soleil | $27 - $84 | 83% |
| City Of North Las Vegas | $27 - $147 | 83% |
| Great West Healthcare | $27 - $84 | 83% |
| Kaiser | $27 - $84 | 83% |
| National Security Technologies | $27 - $84 | 83% |
| American Postal Workers Health Plan | $30 - $323 | 93% |
| Las Vegas Firefighters 1285 | $30 - $147 | 93% |
| Surest | $30 - $323 | 93% |
| Switch | $30 - $147 | 93% |
| UnitedHealthcare | $30 - $323 | 93% |
| Ambetter / Centene | $31 - $185 | 96% |
| Blue Cross Blue Shield | $31 - $84 | 96% |
| Molina | $31 - $185 | 96% |
| Sierra Health And Life | $31 - $202 | 96% |
| Boyd Group | $37 - $147 | 114% |
| Bricklayers Local 13 | $37 - $147 | 114% |
| Caesar'S Entertainment | $37 - $147 | 114% |
| California Ironwork Field Welfare | $37 - $84 | 114% |
| Electrical Workers | $37 - $147 | 114% |
| Laborers Health And Welfare | $37 - $147 | 114% |
| Operating Engineers | $37 - $147 | 114% |
| Plumbers & Pipefitters Loc 525 | $37 - $147 | 114% |
| Sheet Metal Workers | $37 - $84 | 114% |
| So Ca Pipe Trades H&W | $37 - $84 | 114% |
| Southwest Carpenters H&W | $37 - $84 | 114% |
| Teamsters Local 14 | $37 - $147 | 114% |
| Teamsters Local 631 | $37 - $147 | 114% |
| Teamsters Local 986 | $37 - $147 | 114% |
| Ufcw Local 711 Retail Clerks | $37 - $147 | 114% |
| Aetna | $50 - $151 | 154% |
| Coventry | $55 | 170% |
| Mail Handlers Benefit Plan | $55 | 170% |
| Nevada Energy | $55 | 170% |
| First Health | $64 | 198% |
| Health Net | $64 - $286 | 198% |
| Three Rivers Provider Network | $64 | 198% |
| Advantra Freedom | $84 | 259% |
| Alignment Health | $101 | 312% |
| Clark County Detention Center | $101 | 312% |
| Scan | $101 | 312% |
| Laughlin Coalition | $131 | 404% |
| City Of Henderson | $147 | 454% |
| Clark County Epo | $147 | 454% |
| Clark County Firefighters 1908 | $147 | 454% |
| Clark County Self Funded | $147 | 454% |
| Culinary Workers Hwf | $147 | 454% |
| Employee Painters Trust | $147 | 454% |
| Las Vegas Metro Police Dept | $147 | 454% |
| Mgm Grand | $147 | 454% |
| Mirage Las Vegas | $147 | 454% |
| Nevada Hand | $147 | 454% |
| Resorts World Las Vegas | $147 | 454% |
| Wynn Resorts | $147 | 454% |
| Arroweye Solutions | $153 | 472% |
| Dignity Health | $153 | 472% |
| Golden Entertainment | $153 | 472% |
| Golden Nugget Hotel & Casino | $153 | 472% |
| Marshall Retail Group | $153 | 472% |
| P3 Health Partners | $153 | 472% |
| Pli Las Vegas | $153 | 472% |
| Rebel Oil Company | $153 | 472% |
| State Of Nevada | $153 | 472% |
| Stations Casinos | $153 | 472% |
| Teacher'S Health Trust | $153 | 472% |
| Truline Corporation | $153 | 472% |
| Venetian/Palazzo | $153 | 472% |
| Health Direct Partners | $185 | 571% |
| Selecthealth | $185 | 571% |
| Jw Marriott | $202 | 623% |
| Nevada Preferred Professionals | $202 | 623% |
| Prominence Health Plan | $202 | 623% |
| Universal Health Network (Uhn) | $202 | 623% |
| Zuffa | $202 | 623% |
| Hometown Health Plan Of Nevada | $243 | 750% |
| One Health Plan | $243 | 750% |
| Va Pc3 (Va Choice) | $302 | 932% |
| Las Vegas Sand Corps | $323 | 997% |