Occupational therapy (self-care training)
Facility: Ohio Valley Surgical Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $11,885
- Cash Discount Price: $77
- vs. Medicare Baseline: 366.82x 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 36682% of the Medicare baseline (a markup of 36582%). 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 |
|---|---|---|
| Mmoh | $58 - $11,885 | 179% |
| Mmo Cin. Hmo | $59 - $81 | 182% |
| Mmoh (Supermed) | $59 - $60 | 182% |
| Aetna | $69 - $20,896 | 213% |
| Geha | $69 - $20,896 | 213% |
| Genworth | $69 - $20,896 | 213% |
| Mail Handlers | $69 - $20,896 | 213% |
| Meritain | $69 - $20,896 | 213% |
| Meritain Heatlh | $69 - $20,896 | 213% |
| Mhbp | $69 - $20,896 | 213% |
| Ngs Coresource | $69 - $20,896 | 213% |
| Nippon Life | $69 - $20,896 | 213% |
| Pacific Source | $69 - $20,896 | 213% |
| Personify Health | $69 - $20,896 | 213% |
| Medicare (plans) | $77 - $12,264 | 238% |
| Luminare Health | $116 | 358% |
| Medben | $116 | 358% |
| Ohio Health | $116 | 358% |
| Preferred Health | $116 | 358% |
| Blue Cross Blue Shield | $127 - $40,293 | 392% |
| Cigna | $165 - $18,817 | 509% |
| Healthgram | $165 - $18,817 | 509% |
| Nalc | $165 - $18,817 | 509% |
| Samba | $165 - $18,817 | 509% |
| Sbma | $165 - $18,817 | 509% |
| Unified Group | $165 - $18,817 | 509% |
| Medicaid / KanCare | $3,557 - $17,827 | 10978% |
| Amerihealth Caritas Of Ohio | $3,657 | 11287% |
| Buckeye Community Health Plan | $4,022 | 12414% |
| UnitedHealthcare | $4,022 - $17,571 | 12414% |
| Molina Mcd | $4,084 | 12605% |
| Caresource | $4,364 - $17,827 | 13469% |
| Humana | $4,493 - $11,919 | 13867% |
| Aarp | $11,885 | 36682% |
| Aarp Supplemental | $11,885 | 36682% |
| American Continental Insurance | $11,885 | 36682% |
| American Continental Life | $11,885 | 36682% |
| American Republic | $11,885 | 36682% |
| American Retirement | $11,885 | 36682% |
| Aultcare Primetime Health Plan | $11,885 | 36682% |
| Bankers Fidelity | $11,885 | 36682% |
| Bankers Life And Casualty | $11,885 | 36682% |
| Central States | $11,885 | 36682% |
| Champus | $11,885 | 36682% |
| Communicare Advantage | $11,885 | 36682% |
| Everest | $11,885 | 36682% |
| Gateway Health Plan | $11,885 | 36682% |
| Medigold | $11,885 | 36682% |
| Molina | $11,885 | 36682% |
| Molina Dual Mcr | $11,885 | 36682% |
| Molina Marketplace | $11,885 | 36682% |
| Molina Dual Mcr | $11,885 | 36682% |
| Molina Mcr | $11,885 | 36682% |
| Molina Mcr Mcd | $11,885 | 36682% |
| Molina Mcr+Mcd | $11,885 | 36682% |
| Patient No Pay | $11,885 | 36682% |
| Prosperity Supplement | $11,885 | 36682% |
| Self Pay Imaging | $11,885 | 36682% |
| Wellcare By Allwell | $11,885 | 36682% |
| Wraparound Pl Supp | $11,885 | 36682% |
| The Health Plan | $12,479 | 38515% |
| Devoted Health | $13,707 | 42306% |
| Employer Direct | $15,703 | 48466% |
| Golden Rule | $17,571 | 54231% |
| Medica | $17,571 | 54231% |
| Oxford | $17,571 | 54231% |
| Shl | $17,571 | 54231% |
| Surest | $17,571 | 54231% |
| Ushealth | $17,571 | 54231% |
| Caresourse | $17,827 | 55022% |