Occupational therapy (self-care training)
Facility: Las Palmas Medical Center A Campus of Lpds Healthc
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $262
- Cash Discount Price: $638
- vs. Medicare Baseline: 8.09x 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 809% of the Medicare baseline (a markup of 709%). 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 |
|---|---|---|
| El Paso First Health Plans | $24 - $45 | 74% |
| Superior Health Plan | $26 - $49 | 80% |
| Blue Cross Blue Shield | $27 - $263 | 83% |
| Aetna | $28 - $314 | 86% |
| Amerigroup | $28 - $32 | 86% |
| Arcadian Health Plan | $28 - $32 | 86% |
| Cigna | $28 - $87 | 86% |
| Devoted Health | $28 - $32 | 86% |
| St David’S Hospice | $28 - $32 | 86% |
| Triwest Healthcare Alliance | $28 - $32 | 86% |
| United | $28 - $361 | 86% |
| UnitedHealthcare | $28 - $79 | 86% |
| Wellmed | $28 - $31 | 86% |
| Alignment Health Plan | $29 - $32 | 90% |
| American Health Plan Of Texas | $29 - $33 | 90% |
| Clover Insurance Company | $29 - $33 | 90% |
| Provider Partners Health Plan | $29 - $33 | 90% |
| Shared Health | $29 - $33 | 90% |
| Wellcare Of Tx | $29 - $32 | 90% |
| Western Sky Community Care | $29 - $33 | 90% |
| Imperial Insurance | $30 - $35 | 93% |
| Pyramid Life | $30 - $34 | 93% |
| Triwest Health Alliance | $31 | 96% |
| Molina Healthcare Mcr | $33 - $38 | 102% |
| Universal Health Pffs Nc | $33 - $38 | 102% |
| Bravo Health | $37 - $43 | 114% |
| Oscar | $45 - $83 | 139% |
| Corvel Corporation | $55 - $62 | 170% |
| Molina Healthcare | $57 - $65 | 176% |
| Bienvivir Senior Health | $74 - $137 | 228% |
| Healthcare Highways | $84 - $154 | 259% |
| First Health | $196 - $361 | 605% |
| Healthsmart Preferred Care | $196 - $442 | 605% |
| Emerging Therapy Solutions | $201 - $554 | 620% |
| Sheriff'S Dept El Paso County Detention | $218 - $402 | 673% |
| Ysleta Del Sur Pueblo | $218 - $402 | 673% |
| Southwest Medical Provider Network | $240 - $442 | 741% |
| Advantage Care Network | $262 - $482 | 809% |
| El Paso First Health Plan | $262 - $482 | 809% |
| Prime Health | $262 - $482 | 809% |
| Texas Workforce Commission | $275 - $506 | 849% |
| Multiplan | $283 - $522 | 873% |
| Phcs | $283 - $522 | 873% |
| Integrated Medical Systems | $305 - $562 | 941% |
| Samsa | $305 - $562 | 941% |
| Danmark - International Contract | $327 - $602 | 1009% |
| Galaxy Health Network | $327 - $602 | 1009% |
| Medcorp Southwest | $349 - $642 | 1077% |
| Usa Managed Care | $358 - $763 | 1105% |
| Affiliated Healthcare | $371 - $683 | 1145% |
| National Provider Network | $392 - $723 | 1210% |