Occupational therapy (self-care training)
Facility: Freestone Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $114
- Cash Discount Price: $263
- vs. Medicare Baseline: 3.52x 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 352% of the Medicare baseline (a markup of 252%). 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 |
|---|---|---|
| Aarp Mcare /Wellmed | $31 | 96% |
| Aetna | $31 - $305 | 96% |
| Allwell Superior Hlth | $31 | 96% |
| Ambetter / Centene | $31 | 96% |
| Care Improvement Plus | $31 | 96% |
| Champva | $31 | 96% |
| Humana | $31 - $381 | 96% |
| Medicare (plans) | $31 | 96% |
| Misc Mcare Replacement | $31 | 96% |
| Pphp Prov Part Hlth Plan | $31 | 96% |
| Scott & White Senior Care | $31 | 96% |
| Superior Hlth Mcare Repl | $31 | 96% |
| Tricare | $31 | 96% |
| Triwest | $31 | 96% |
| Triwest Va Ccn Claims | $31 | 96% |
| UnitedHealthcare | $31 - $114 | 96% |
| Utmb Corr Mgd Care | $31 | 96% |
| Va Vha Office Comm Care | $31 | 96% |
| Veteran'S Administration | $31 | 96% |
| Wellmed | $31 | 96% |
| Blue Cross Blue Shield | $35 - $343 | 108% |
| Scott & White Commercial | $40 | 123% |
| Scott & White Employees | $40 | 123% |
| Workers Compensation | $63 | 194% |
| Mcaid | $78 - $80 | 241% |
| Misc Mcaid Hmo | $78 - $114 | 241% |
| Superior Health Chip | $78 - $80 | 241% |
| Tx Childrens Mcaid | $78 - $80 | 241% |
| Amerigroup | $102 - $114 | 315% |
| Medicaid / KanCare | $103 - $176 | 318% |
| Rightcare S&W Mcaid | $103 - $114 | 318% |
| Superior Health Mcd | $103 - $176 | 318% |
| Gilsbar | $185 - $381 | 571% |
| Cigna | $222 - $229 | 685% |
| Misc Multiplan | $259 - $267 | 799% |
| Misc Multiplan Auto | $259 - $267 | 799% |
| Misc Multiplan Workcomp | $259 - $267 | 799% |
| Self Pay Gt 083123 | $259 - $267 | 799% |
| Self Pay Lt 090123 | $259 - $267 | 799% |
| Aflac | $370 - $381 | 1142% |
| Bankers Life | $370 - $381 | 1142% |
| Fairview Nursing Home | $370 - $381 | 1142% |
| Icare | $370 - $381 | 1142% |
| Inmate Freestone Co | $370 - $381 | 1142% |
| Misc Hospice | $370 - $381 | 1142% |
| Miscellaneous | $370 - $381 | 1142% |
| Miscellaneous Auto | $370 - $381 | 1142% |
| Mutual Of Omaha | $370 - $381 | 1142% |
| North American Med Empl | $370 - $381 | 1142% |
| Standard Life Insurance | $370 - $381 | 1142% |
| Tml | $370 - $381 | 1142% |
| Zelis Healthcare | $370 - $381 | 1142% |