Occupational therapy (self-care training)
Facility: Memorial Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $47
- Cash Discount Price: $72
- vs. Medicare Baseline: 1.45x 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 |
|---|---|---|
| Ambetter / Centene | $11 - $58 | 34% |
| Capstar Health Network-All Plans | $20 - $138 | 62% |
| Cigna | $20 - $128 | 62% |
| Healthcare Highways-All Plans | $22 - $138 | 68% |
| Prime Healthcare Services-All Plans | $23 - $120 | 71% |
| Blue Cross Blue Shield | $25 - $72 | 77% |
| Humana | $27 - $138 | 83% |
| Corvel Work Comp-All Plans | $28 - $146 | 86% |
| Independent Med Sys Ppo-All Plans | $28 - $146 | 86% |
| Multiplan Mcr Adv | $28 - $48 | 86% |
| Multiplan Phcs Ppo-All Other Plans | $28 - $146 | 86% |
| Provider Select Ppo-All Plans | $28 - $146 | 86% |
| Three Rivers Ppo-All Plans | $28 - $146 | 86% |
| UnitedHealthcare | $28 - $138 | 86% |
| Usa Mso - All Plans | $28 - $146 | 86% |
| Triwest Va Pccc-All Plans | $31 - $47 | 96% |
| Amerigroup Mcr Adv-All Other Plans | $32 - $48 | 99% |
| Care Improvement Plus - All Other Plans | $32 - $48 | 99% |
| Care Improvement Plus Mcr | $32 - $49 | 99% |
| Superior Allwell Mcr Adv-All Other Plans | $32 - $48 | 99% |
| Universal American Mcr-All Other Plans | $32 - $48 | 99% |
| Amerigroup Chip | $33 - $83 | 102% |
| Amerigroup Star | $33 - $83 | 102% |
| Amerigroup Star Kids | $33 - $83 | 102% |
| Amerigroup Star Plus | $33 - $83 | 102% |
| Comm Health Chip | $33 - $83 | 102% |
| Comm Health Perinatal-All Other Plans | $33 - $83 | 102% |
| Molina Chip/Star-All Plans | $33 - $83 | 102% |
| Scott & White Chip/Star-All Plans | $33 - $83 | 102% |
| Superior Chip/Star | $33 - $83 | 102% |
| Texas Childrens Hp - All Plans | $33 - $83 | 102% |
| Universal American Snp | $33 - $51 | 102% |
| Comm Health Mcaid Hmo | $35 - $87 | 108% |
| Comm Health Star | $35 - $87 | 108% |
| Coventry First Hlth Hmo Ppo-All Other Plans | $39 - $138 | 120% |
| Coventry First Hlth Mcr Adv | $39 - $48 | 120% |
| Galaxy Health Network-All Plans | $46 - $146 | 142% |
| Aetna | $138 | 426% |