Occupational therapy (self-care training)
Facility: Laredo Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $130
- Cash Discount Price: $122
- vs. Medicare Baseline: 4.01x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 401% of the Medicare baseline (a markup of 301%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Self Pay | $29 - $54 | 90% |
| Humana | $31 | 96% |
| Medicare (plans) | $31 | 96% |
| Node Champva | $31 | 96% |
| Node Hospice Non Par Agree | $31 | 96% |
| Tricare | $31 | 96% |
| UnitedHealthcare | $31 - $118 | 96% |
| Veterans Eval Services | $31 | 96% |
| Aetna | $32 - $240 | 99% |
| American Health | $32 | 99% |
| Blue Cross Blue Shield | $32 - $147 | 99% |
| Node Ice Health Service Corps | $32 | 99% |
| Node Va | $32 | 99% |
| Provider Partners Health Plan | $32 | 99% |
| Triwest | $32 | 99% |
| Node Amerigroup Mcr Adv | $33 | 102% |
| Node Tihp Mcr Adv | $33 | 102% |
| Node Wellpoint Mcr Adv | $33 | 102% |
| Superior | $33 | 102% |
| Industrial Rehab | $36 | 111% |
| Node Us Dept Of Labor | $49 | 151% |
| Lonestar Athletic | $50 | 154% |
| Node Molina Health Exchange | $52 | 160% |
| Node Brookshire Brothers | $55 | 170% |
| Node Brookshire Brothers Work Comp Tx | $59 | 182% |
| Coventry Hcn Tx Work Comp | $60 | 185% |
| Health Smart | $60 - $289 | 185% |
| Node Superior Commercial Exchange | $63 | 194% |
| Tx Work Comp | $63 | 194% |
| Imo Work Comp | $72 | 222% |
| Node Naphcare | $72 | 222% |
| Cigna | $124 - $264 | 383% |
| Medicaid / KanCare | $124 | 383% |
| Molina | $124 | 383% |
| Tx Workforce Commission | $136 | 420% |
| Mutual Of Omaha | $268 - $392 | 827% |
| Multiplan Primary | $310 | 957% |
| Medical Control | $343 | 1059% |
| Accountable Health Plans | $351 - $372 | 1083% |
| Health Headquarters | $351 | 1083% |
| Multiplan | $359 | 1108% |
| Nha | $363 | 1120% |
| Galaxy Health Network | $366 | 1130% |
| Cchn | $372 | 1148% |
| Nppn Plan Vista | $372 | 1148% |
| Ppo Next | $372 | 1148% |