CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: HCA Houston Healthcare Conroe

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $40
  • Cash Discount Price: $387
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at HCA Houston Healthcare Conroe is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $387. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.23x the Medicare baseline. Located in 504 Medical Center Blvd, Conroe, TX.
Cash / Self-Pay
$387

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $387 (1194%)
Insurance Median: $40 (123%)
Cash: $387 (1194% of Medicare)
Ins. Median: $40 (123% 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
Superior Health Plan $22 - $33 68%
Oscar $27 - $78 83%
Aetna $28 - $175 86%
Amerigroup $28 - $56 86%
Blue Cross Blue Shield $28 - $141 86%
Cigna $28 - $32 86%
Devoted Health $28 - $32 86%
Geo Group - Joe Corley Detention Facility $28 - $32 86%
Humana $28 - $331 86%
Kelsey Seybold $28 - $32 86%
Triwest Healthcare Alliance $28 - $32 86%
United $28 - $181 86%
Van Lang Ipa $28 - $32 86%
Wellmed $28 - $31 86%
American Health Plan $29 - $33 90%
Integranet Amerigroup Ipa $29 - $32 90%
Procare Advantage $29 - $33 90%
Provider Partners Health Plan Of Texas $29 - $33 90%
Shared Health $29 - $33 90%
Wellcare $29 - $32 90%
Molina $30 - $34 93%
Christus (Usfhp) $32 99%
Universal Healthcare Group $33 - $38 102%
Verda Health Plan $36 - $41 111%
Community Health Choice $40 - $46 123%
Superior $40 - $49 123%
Community Health Choice Mcd $48 - $52 148%
Corvel Corporation $55 - $62 170%
Omni Healthcare $58 - $66 179%
Molina Healthcare $60 - $68 185%
Texas Childrens Health Plans $76 - $95 235%
Tx Workforce Commission $89 - $96 275%
Healthsmart Preferred Care $160 - $342 494%
Fidelis Securecare Of Tx $167 - $181 515%
Coventry National First Health $198 - $214 611%
Physicians Cooperative Of Texas $205 - $221 633%
Rockport Workers Comp $205 - $221 633%
Independent Medical System $223 - $241 688%
National Healthcare Solutions $223 - $241 688%
Southwest Medical $223 - $241 688%
Coastal Comp $242 - $261 747%
Multiplan $279 - $342 861%
Texas Athletic Network $300 - $600 926%
Physicians, Inc $316 - $342 975%
Affiliated Ppo $335 - $362 1034%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 504 Medical Center Blvd, Conroe, TX 77304
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals