CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Hillcrest Hospital South

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $87
Cash Discount Price: $66
vs. Medicare Baseline: 2.69x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Hillcrest Hospital South is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 2.69x the Medicare baseline. Located in 8801 South 101St East Avenue, Tulsa, OK.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $66 (204%)

Insurance Median: $87 (269%)

Cash: $66 (204% of Medicare)

Ins. Median: $87 (269% 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 269% of the Medicare baseline (a markup of 169%). 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
Healthcare Highways [2210]	$55 - $95	170%
Hooray Health [8000]	$55	170%
Oncology Patient Assistance Programs [2295]	$55	170%
Oscar Insurance Company [7005]	$55	170%
Osma Health Network [2345]	$55	170%
Healthscope Benefits [2290]	$78	241%
UnitedHealthcare	$78	241%
Cigna	$87	269%
National Association Of Letter Carriers [1695]	$87	269%
Pba [1775]	$87	269%
Resource One Administrators [2815]	$95	293%
Web Tpa [2115]	$95	293%
The Kempton Group Administrators [2905]	$99	306%
Medica [2910]	$130	401%
Multiplan [1680]	$130	401%

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 $66.
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 South 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.