Occupational therapy (self-care training)
Facility: Longview Regional Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $60
- Cash Discount Price: $56
- vs. Medicare Baseline: 1.85x 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 |
|---|---|---|
| Self Pay | $15 - $22 | 46% |
| Healthspring | $31 | 96% |
| Humana | $31 | 96% |
| Medicare (plans) | $31 | 96% |
| Node Champva | $31 | 96% |
| Tricare | $31 | 96% |
| UnitedHealthcare | $31 - $69 | 96% |
| Veterans Eval Services | $31 | 96% |
| Aetna | $32 - $168 | 99% |
| American Health Mcr Adv | $32 | 99% |
| Blue Cross Blue Shield | $32 - $73 | 99% |
| Node Hospice Non Par Agree | $32 | 99% |
| Node Triwest | $32 | 99% |
| Node Va | $32 | 99% |
| Provider Partners Health Plan | $32 | 99% |
| Node Amerigroup Mcr Adv | $33 | 102% |
| Superior | $33 - $47 | 102% |
| Wellness Pointe | $38 | 117% |
| Node Us Dept Of Labor | $49 | 151% |
| Access Direct Platinum | $54 | 167% |
| Node Brookshire Brothers | $55 | 170% |
| Node Brookshire Brothers Work Comp Tx | $59 | 182% |
| Texas Rehab Commission | $62 | 191% |
| Work Comp | $63 | 194% |
| Nx Health Network | $79 | 244% |
| Cigna | $123 | 380% |
| Health Smart | $136 - $173 | 420% |
| Gregg Co Detention Center | $143 | 441% |
| Verity Health Net | $143 | 441% |
| Multiplan | $160 - $210 | 494% |
| Aim Administrators | $185 | 571% |