CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Medical Center of McKinney

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $39
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Medical Center of McKinney is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.20x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $132 (407%)
Insurance Median: $39 (120%)
Cash: $132 (407% of Medicare)
Ins. Median: $39 (120% 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 $9 - $33 28%
Cigna $18 - $106 56%
United $25 - $32 77%
Blue Cross Blue Shield $27 - $187 83%
Oscar $27 - $28 83%
Aetna $28 - $179 86%
Amerigroup $28 - $32 86%
Care N Care $28 - $32 86%
Devoted Health $28 - $32 86%
Humana $28 - $243 86%
Mutual Of Omaha $28 - $32 86%
Triwest Veterans $28 - $32 86%
Wellmed $28 - $31 86%
American Health Plan Of Texas, Inc. $29 - $33 90%
Integranet $29 - $32 90%
Procare Advantge $29 - $33 90%
Provider Partners Health Plan $29 - $33 90%
Texas Independent Health Plan $29 - $33 90%
Wellcare $29 - $32 90%
Cenpatico $30 - $34 93%
Imperial Insurance Company $30 - $35 93%
Molina $30 - $34 93%
Universal Healthcare Group $33 - $38 102%
Unicare $34 - $133 105%
Verda Health Plan $36 - $41 111%
Bravo Health $42 - $47 130%
Healthcare Highways $44 - $45 136%
City Of Mckinney $46 142%
Superior $50 - $71 154%
Usa Managed Care $53 - $106 164%
Corvel Corporation $55 - $62 170%
Fidelis Securecare $59 - $60 182%
National Choicecare $66 204%
Pc Texas Partners $72 - $73 222%
Physicians Coop Of Tx $72 - $73 222%
Rockport Health Group $72 - $73 222%
Molina Healthcare $73 - $83 225%
Averde Health, Inc $76 - $77 235%
Magellan Bh $79 - $80 244%
Value Options Behavioral Health $79 - $80 244%
Coastal Comp Health Networks $92 - $93 284%
Mega Life $92 - $93 284%
Multiplan Phcs $92 - $93 284%
Lewisville Isd/Dls Consulting $99 - $100 306%
Compsych Corporation $105 - $106 324%
Healthsmart Preferred Care $105 - $106 324%
Galaxy Health Network $112 - $113 346%
Independent Medical Systems $131 - $133 404%
National Healthcare Solutions $131 - $133 404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals