CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Medical City Arlington

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $48
  • Cash Discount Price: $506
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Medical City Arlington is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $506. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.48x the Medicare baseline. Located in 3301 Matlock Road, Arlington, TX.
Cash / Self-Pay
$506

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $506 (1562%)
Insurance Median: $48 (148%)
Cash: $506 (1562% of Medicare)
Ins. Median: $48 (148% 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
Amerigroup $28 - $32 86%
Blue Cross Blue Shield $28 - $233 86%
Devoted Health $28 - $32 86%
Humana $28 - $243 86%
Mutual Of Omaha $28 - $32 86%
Triwest Veterans $28 - $32 86%
Wellmed $28 - $32 86%
Aetna $29 - $381 90%
Care N Care $29 - $33 90%
Cigna $29 - $73 90%
Integranet $29 - $33 90%
United $29 - $98 90%
Wellcare $29 - $33 90%
American Health Plan Of Texas, Inc. $30 - $34 93%
Procare Advantge $30 - $34 93%
Provider Partners Health Plan $30 - $34 93%
Superior Health Plan $30 - $37 93%
Texas Independent Health Plan $30 - $34 93%
Imperial Insurance Company $31 - $35 96%
Molina $31 - $35 96%
Triwest Health Alliance $32 99%
Universal Healthcare Group $34 - $39 105%
Verda Health Plan $37 - $42 114%
Bravo Health $43 - $48 133%
Superior $51 - $72 157%
Usa Managed Care $54 - $419 167%
Corvel Corporation $56 - $64 173%
Molina Healthcare $74 - $84 228%
Unicare $93 - $524 287%
Oscar $101 - $109 312%
Healthcare Highways $165 - $177 509%
City Of Mckinney $219 - $236 676%
Fidelis Securecare $219 - $236 676%
Global Sports Services $244 - $262 753%
National Choicecare $244 - $262 753%
Pc Texas Partners $268 - $288 827%
Physicians Coop Of Tx $268 - $288 827%
Rockport Health Group $268 - $288 827%
Averde Health, Inc $283 - $304 873%
Coastal Comp Health Networks $341 - $367 1052%
Mega Life $341 - $367 1052%
Multiplan Phcs $341 - $367 1052%
Healthsmart Preferred Care $346 - $372 1068%
Lewisville Isd/Dls Consulting $366 - $393 1130%
Usc Health Services $390 - $419 1204%
Galaxy Health Network $415 - $445 1281%
Texas Instruments $439 - $471 1355%
Independent Medical Systems $488 - $524 1506%
National Healthcare Solutions $488 - $524 1506%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Matlock Road, Arlington, TX 76015
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals