CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Union Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $43
  • Cash Discount Price: $165
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Union Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.33x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$165

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $165 (509%)
Insurance Median: $43 (133%)
Cash: $165 (509% of Medicare)
Ins. Median: $43 (133% 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
Summacare $20 - $119 62%
Buckeye $24 - $27 74%
Molina $24 - $29 74%
Caresource $25 - $27 77%
United $25 - $125 77%
Aetna $26 - $254 80%
Amerihealth $26 - $30 80%
Blue Cross Blue Shield $29 - $135 90%
Cigna $31 - $114 96%
Humana $31 - $41 96%
Mmo $31 - $165 96%
The Health Plan $31 - $218 96%
Valor $31 - $41 96%
Aultcare $32 - $114 99%
Communicare $32 - $43 99%
Perennial Health $33 - $44 102%
Pphp $33 - $34 102%
Cc Ehp $34 - $189 105%
Zing Health $34 - $76 105%
Devoted Health $41 127%
UnitedHealthcare $41 127%
Upmc $41 - $152 127%
Oscar $44 - $98 136%
Ohcp $63 - $123 194%
Omas $82 - $127 253%
Healthsmart $90 - $140 278%
Phphi $98 - $152 302%
Amish Community Aid Plan $114 - $127 352%
Gms $114 - $178 352%
Consociate Health $122 - $190 377%
Ohio Healthy $137 423%
Multiplan $147 - $229 454%
Php $152 469%
Medical Benefit Corp $178 549%
Frontpath $229 707%
Managed Care Services $229 707%
Tertiary Care Network $229 707%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals