Occupational therapy (self-care training)
Facility: St David's Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $41
- Cash Discount Price: $184
- vs. Medicare Baseline: 1.27x 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.
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 |
|---|---|---|
| Superior Health Plan | $6 - $35 | 19% |
| Oscar | $25 - $44 | 77% |
| Wellmed | $27 - $32 | 83% |
| Aetna | $28 - $202 | 86% |
| Blue Cross Blue Shield | $28 - $201 | 86% |
| Cigna | $28 - $33 | 86% |
| Devoted Health | $28 - $33 | 86% |
| Humana | $28 - $33 | 86% |
| Odyssey Hospice | $28 - $33 | 86% |
| St David’S Hospice | $28 - $33 | 86% |
| Triwest Healthcare Alliance | $28 - $33 | 86% |
| United | $28 - $93 | 86% |
| American Health Plan Of Texas | $29 - $35 | 90% |
| Provider Partners Health Plan | $29 - $35 | 90% |
| Shared Health | $29 - $35 | 90% |
| Texas Independent Health Plan | $29 - $35 | 90% |
| Triwest Veterans | $29 - $33 | 90% |
| Wellcare | $29 - $35 | 90% |
| Imperial Insurance | $30 - $37 | 93% |
| Moda | $30 - $49 | 93% |
| Molina Healthcare | $30 - $36 | 93% |
| Pyramid Life | $30 - $36 | 93% |
| Triwest Health Alliance | $31 - $33 | 96% |
| Universal Health | $33 - $40 | 102% |
| Amerigroup | $34 | 105% |
| Austin Fc | $35 - $42 | 108% |
| Covenant Management Systems | $37 - $60 | 114% |
| Sendero | $37 - $57 | 114% |
| Healthcare Highways | $38 - $62 | 117% |
| Imo Med - Select Network | $39 - $62 | 120% |
| Naphcare | $43 - $52 | 133% |
| Moda Health | $46 - $77 | 142% |
| Seven Corners | $46 - $52 | 142% |
| Texas Healthcare Foundation Heb | $48 - $77 | 148% |
| Texas Workforce Commission | $50 - $81 | 154% |
| Corvel Corporation | $55 - $66 | 170% |
| Averde Health | $58 - $93 | 179% |
| Comanche County | $64 - $104 | 198% |
| Healthsmart Preferred Care | $71 - $166 | 219% |
| Independent Medical Systems | $71 - $114 | 219% |
| Physicians Cooperative Of Texas | $71 - $114 | 219% |
| Prime Health | $77 - $124 | 238% |
| First Health | $81 - $149 | 250% |
| Coastal Comp Health Networks | $84 - $135 | 259% |
| National Health Care | $84 - $135 | 259% |
| National Choicecare | $88 - $104 | 272% |
| Medcorp Southwest | $97 - $155 | 299% |
| Beech Street | $116 - $186 | 358% |
| Medical Control Network Solutions | $116 - $186 | 358% |
| Multiplan | $116 - $186 | 358% |
| Occunet | $123 - $145 | 380% |
| Texas Municipal League | $123 - $145 | 380% |
| Rockport Healthcare Group | $141 - $186 | 435% |
| Bce Emergis Corporation | $158 - $186 | 488% |