CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $53
Cash Discount Price: $96
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Crystal Clinic Orthopaedic Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.64x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $96 (296%)

Insurance Median: $53 (164%)

Cash: $96 (296% of Medicare)

Ins. Median: $53 (164% 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
Aultcare - All Plans	$22 - $66	68%
Bc Blue Access	$27 - $395	83%
Bc Ohi/Ohii	$27 - $355	83%
Bc Pathway	$27 - $259	83%
Bc Preferred	$27 - $395	83%
Bc Trad - All Other Plans	$27 - $395	83%
Health Oh Network - All Plans	$29 - $124	90%
Ohio Health Choice - All Plans	$29 - $124	90%
Bc Mcr Adv	$31	96%
Summacare Mcr Adv	$31	96%
UnitedHealthcare	$31 - $436	96%
Multiplan - All Plans	$32 - $137	99%
Summacare Comm - All Other Plans	$34 - $383	105%
Cigna	$40 - $125	123%
The Health Plan - All Plans	$40 - $62	123%
Healthsmart - All Plans	$41 - $176	127%
Med Mutual Nas	$44 - $129	136%
Med Mutual Medflex	$388	1198%
Med Mutual Aca	$441	1361%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$484	1494%
Aetna	$491	1515%

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 $96.
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 Crystal Clinic Orthopaedic Center 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.