CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: St Clair Hospital

Billing Code: 97535 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$32
about 1.0× the $32 Medicare rate · typically $31–$41
modeled estimate · not a bill or quote
What this hospital charges insurers
$34
About the fair price
about $2 over the fair price · 1.1× Medicare
Medicare pays $32 Fair price $32 This hospital $34 Cash price $24 Hospital's list price $98

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $21 Priciest $34

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Occupational therapy (self-care training) is about $32 (about 1.0× the $32 Medicare rate). St Clair Hospital charges insurers about $34, or about $24 in cash — about the fair price. Located in Pittsburgh, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $31 - $34 96%
Blue Cross Blue Shieldmajor $28 - $62 86%
Aetnamajor $32 - $83 99%
Cignamajor $32 - $125 99%
Humanamajor $31 96%
AmeriHealth $31 96%
Geisinger $32 99%
HealthPartners $33 102%
UPMC Health Plan $15 - $56 46%
+ 3 smaller / regional plans $32 - $74

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 1000 Bower Hill Road, Pittsburgh, PA 15243
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals