CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Ohiohealth Morrow County Hospital

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $39
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Ohiohealth Morrow County Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.20x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $68 (210%)
Insurance Median: $39 (120%)
Cash: $68 (210% of Medicare)
Ins. Median: $39 (120% 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
Blue Cross Blue Shield $38 - $80 117%
Medicaid / KanCare $38 - $39 117%
Medicare (plans) $38 - $39 117%
UnitedHealthcare $38 - $85 117%
Aetna $39 - $89 120%
Amerihealth Caritas - All Plans $39 120%
Humana $39 - $97 120%
Caresource Marketplace - All Other Plans $48 148%
Molina Exchange - All Other Plans $63 194%
Medical Mutual Of Ohio Marketplace $78 241%
Ohiohealthy Network - All Other Plans $78 241%
Ohiohealthy Preferred $78 241%
Medical Mutual Of Ohio Comm - All Other Plans $84 259%
Medical Mutual Of Ohio - Admin Serv $88 272%
Phcs - All Plans $96 296%
Cigna $98 302%
Multiplan - All Plans $99 306%
Healthstar Comm - All Plans $100 309%
Beech Street - All Plans $101 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals