CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Trident Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $32
  • Cash Discount Price: $345
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Trident Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 0.99x the Medicare baseline. Located in 9330 Medical Plaza Dr, Charleston, SC.
Cash / Self-Pay
$345

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $345 (1065%)
Insurance Median: $32 (99%)
Cash: $345 (1065% of Medicare)
Ins. Median: $32 (99% 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
Blue Choice $15 46%
United $15 - $155 46%
Advantage Hospice $27 - $31 83%
Agape Hospice $27 - $31 83%
Arcadian $27 - $31 83%
Blue Cross Blue Shield $27 - $328 83%
Companion $27 - $31 83%
Devoted Health $27 - $31 83%
Humana $27 - $259 83%
Odyssey Hospice $27 - $31 83%
United Behavioral Health $27 - $31 83%
Absolute Total Care $28 - $62 86%
Aetna $28 - $31 86%
Boldage Pace $28 - $32 86%
Molina $28 - $62 86%
Wellcare $28 - $32 86%
Clover $29 - $33 90%
Eon Health $29 - $33 90%
Cigna $30 - $34 93%
Sc State Employees $32 99%
Universal Healthcare Group $33 - $37 102%
Corvel Corporation $37 - $43 114%
Employer'S Health Network $37 - $43 114%
Prime Health $37 - $293 114%
Heritage Summit $40 - $46 123%
Seven Corners $48 - $54 148%
Naphcare $57 - $65 176%
Blue Choice Health Plan $58 179%
Nhc Advantage $66 204%
Pruitt Health $66 204%
Medcost $132 - $194 407%
Select Health $148 457%
Employers Health Network $155 478%
Occunet $172 531%
Vocational Rehab $186 574%
First Health $252 778%
Mhnet $259 799%
Evernorth $276 852%
Multiplan $293 904%
Novanet $310 957%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9330 Medical Plaza Dr, Charleston, SC 29406
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals