CMS Price Transparency Data
Occupational therapy (self-care training)
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 97535 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97535
- Insurance Median: $54
- Cash Discount Price: $59
- vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Mercy Hospital Ardmore, Inc is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.67x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$59
Average discount available for prompt cash payment at this facility.
Insurance Median
$54
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: $59 (182%)
Insurance Median: $54 (167%)
Cash: $59 (182% of Medicare)
Ins. Median: $54 (167% 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 |
|---|---|---|
| Aetna | $29 - $57 | 90% |
| Humana | $29 - $62 | 90% |
| Medicaid / KanCare | $29 - $41 | 90% |
| Blue Cross Blue Shield | $30 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $30 | 93% |
| Cigna | $30 - $55 | 93% |
| Cross Timbers Hospice [20098] | $30 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $30 | 93% |
| Elara Caring Aspire Hospice Contracted [320433] | $30 | 93% |
| Elara Caring Aspire Hospice [20433] | $30 | 93% |
| Globalhealth Contracted [320145] | $30 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $30 | 93% |
| Halo Hcr Inc Hospice [20432] | $30 | 93% |
| Independent Health [20197] | $30 | 93% |
| Indian Health Service Contracted [320198] | $30 | 93% |
| Kindful Hospice Contracted [320434] | $30 | 93% |
| Kindful Hospice [20434] | $30 | 93% |
| Medical Associates Health [20444] | $30 | 93% |
| Medicare (plans) | $30 - $90 | 93% |
| Mercy Hospice Okc [20252] | $30 | 93% |
| Provider Partners Health Plans Contracted [320450] | $30 | 93% |
| Qual Choice Contracted [320325] | $30 | 93% |
| Tribute Health Plan Mcr Contracted [320338] | $30 | 93% |
| Tricare | $30 | 93% |
| UnitedHealthcare | $30 - $112 | 93% |
| Healthcare Highways Plus Contracted [320175] | $35 - $54 | 108% |
| Webtpa Contracted [320417] | $38 | 117% |
| Osma Health Contracted [320292] | $40 | 123% |
| Ambetter / Centene | $41 | 127% |
| Home State Health Plan Contracted [320187] | $41 | 127% |
| Novasys Contracted [320285] | $41 | 127% |
| Workers Comp [20426] | $43 | 133% |
| Community Care Contracted [320080] | $45 - $63 | 139% |
| Health Choice Contracted [320166] | $50 | 154% |
| Aither Health Contracted [320449] | $54 | 167% |
| Auxiant Contracted [320462] | $54 - $58 | 167% |
| Benefit Management Contracted [320052] | $54 - $58 | 167% |
| Ebms Contracted [320493] | $54 | 167% |
| Healthlink Contracted [320179] | $54 - $58 | 167% |
| Imagine 360 Contracted [320494] | $54 | 167% |
| Mercy Benefit Admin Contracted [320251] | $54 - $58 | 167% |
| Quik Trip Contracted [320447] | $54 | 167% |
| Reflect Health Contracted [320492] | $54 | 167% |
| Show-Me Health Administrators Contracted [320483] | $54 | 167% |
| Yuzu Health Contracted [320521] | $54 | 167% |
| Federal Medical Center Contracted [320127] | $58 | 179% |
| Healthscope Contracted [320182] | $58 | 179% |
| Healthsmart Accel Contracted [320183] | $58 | 179% |
| Healthsmart Preferred Care Contracted [320184] | $58 - $67 | 179% |
| Point C Contracted [320238] | $58 | 179% |
| Preferred Health Plan Contracted [320522] | $58 | 179% |
| Tri State Healthcare Coalition Contracted [320379] | $58 | 179% |
| United Medical Resources Contracted [320454] | $58 - $112 | 179% |
| First Health Contracted [320128] | $60 | 185% |
| Globalhealth Contracted [320144] | $61 | 188% |
| Kempton Contracted [320214] | $67 | 207% |
| Preferred Community Choice Contracted [320311] | $68 | 210% |
| Private Health Care Systems Contracted [320320] | $68 - $72 | 210% |
| Multiplan Contracted [320270] | $72 - $81 | 222% |
| Medica Contracted [320239] | $90 - $95 | 278% |