CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Hillcrest Hospital Cushing

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $68
Cash Discount Price: $68
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Hillcrest Hospital Cushing is $68. 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 2.10x the Medicare baseline. Located in 1027 East Cherry Street, Cushing, OK.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $68 (210%)

Cash: $68 (210% of Medicare)

Ins. Median: $68 (210% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 210% of the Medicare baseline (a markup of 110%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Black Lung [6055]	$57	176%
Healthcare Highways [2210]	$57 - $68	176%
Hooray Health [8000]	$57	176%
Lucent Health [6000]	$57	176%
Oncology Patient Assistance Programs [2295]	$57	176%
Oscar Insurance Company [7005]	$57	176%
Healthscope Benefits [2290]	$62	191%
UnitedHealthcare	$62 - $113	191%
Web Tpa [2115]	$68	210%
Cigna	$111	343%
Healthpartners [1500]	$111	343%
National Association Of Letter Carriers [1695]	$111	343%
Pba [1775]	$111	343%
Global Health [1430]	$141	435%
First Health [1375]	$158	488%
Multiplan [1680]	$158	488%
Healthcare Solutions [1485]	$162	500%
Healthsmart [1505]	$194	599%
Pending Ssi [1616]	$228	704%

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 $68.
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 Hillcrest Hospital Cushing 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.