CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Oklahoma Heart Hospital South, LLC

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $55
  • Cash Discount Price: $31
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Oklahoma Heart Hospital South, LLC is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.70x the Medicare baseline. Located in 5200 East I-240 Service Road, Oklahoma City, OK.
Cash / Self-Pay
$31

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $31 (96%)
Insurance Median: $55 (170%)
Cash: $31 (96% of Medicare)
Ins. Median: $55 (170% 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
Healthcare Highways $21 - $55 65%
Geha $24 74%
UnitedHealthcare $24 - $30 74%
Aetna $28 - $42 86%
Humana $28 - $63 86%
Blue Cross Blue Shield $30 - $69 93%
Cigna $30 - $43 93%
Medicare (plans) $30 - $31 93%
Va Ccn $30 93%
Healthscope $39 - $42 120%
Oscar Insurance Company $39 - $42 120%
Webtpa Chickasaw Nation Hch $40 - $43 123%
Ambetter / Centene $42 130%
Webtpa Hobby Lobby Hch $45 - $49 139%
Coventry $50 - $54 154%
Global Health $54 - $58 167%
Sana Benefits $55 - $60 170%
Ufcw $55 - $60 170%
First Health Network $59 - $63 182%
Manhattan Life $59 - $63 182%
Community Care $60 - $64 185%
Phcs $60 - $64 185%
Preferred Community Choice $65 - $70 201%
The Kempton Group $75 231%
Multiplan $76 - $83 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5200 East I-240 Service Road, Oklahoma City, OK 73135
  • CMS Rating: ★★★★★
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals