CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Grand Strand Regional Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $43
  • Cash Discount Price: $396
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Grand Strand Regional Medical Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $396. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.33x the Medicare baseline. Located in 809 82Nd Parkway, Myrtle Beach, SC.
Cash / Self-Pay
$396

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $396 (1222%)
Insurance Median: $43 (133%)
Cash: $396 (1222% of Medicare)
Ins. Median: $43 (133% 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 - $191 46%
Blue Cross Blue Shield $27 - $403 83%
Devoted Health $27 - $31 83%
Humana $27 - $360 83%
United Behavioral Health $27 - $31 83%
Absolute Total Care $28 - $76 86%
Aetna $28 - $31 86%
Boldage Pace $28 - $32 86%
Molina $28 - $76 86%
Wellcare $28 - $32 86%
Clover $29 - $33 90%
Eon Health $29 - $33 90%
Cigna $30 - $137 93%
Health Team Advantage $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 - $360 114%
Heritage Summit $40 - $46 123%
Nhc Advantage $70 - $81 216%
Pruitt Health $70 - $81 216%
Select Health $158 - $182 488%
Medcost $184 - $290 568%
Occunet $184 568%
Vocational Rehab $198 - $229 611%
Employers Health Network $202 - $233 623%
Evernorth $294 - $339 907%
First Health $303 - $350 935%
Global Excel Management $305 - $352 941%
Multiplan $312 - $360 963%
National Choicecare $312 - $360 963%
Novanet $330 - $382 1019%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 809 82Nd Parkway, Myrtle Beach, SC 29572
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals