CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Samaritan Hospital of Troy, New York

Billing Code: 97535 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$60
about 1.9× the $32 Medicare rate · typically $32–$117
modeled estimate · not a bill or quote
Medicare pays $32 Fair price $60 Cash price $70 Hospital's list price $108

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $23 - $383 71%
Blue Cross Blue Shieldmajor $31 - $297 96%
Aetnamajor $33 - $230 102%
Cignamajor $269 830%
Fidelis Care $57 176%
GEHA $230 710%
Harvard Pilgrim $383 1182%
HealthPartners $269 830%
Independent Health $92 284%
MagnaCare $92 284%
Medical Mutual $230 710%
MVP Health Care $158 - $170 488%
Priority Health $269 830%
Tufts Health Plan $269 830%
UniCare $123 380%
+ 22 smaller / regional plans $32 - $316
Government programs also on file: Medicare, Medicaid.
Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals