Occupational therapy (self-care training)
Facility: Pullman Regional Hospital
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $96
- Cash Discount Price: $111
- vs. Medicare Baseline: 2.96x 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 296% of the Medicare baseline (a markup of 196%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $46 - $124 | 142% |
| Community Care Ntwrk Mcare-All Plans | $46 | 142% |
| Humana | $46 | 142% |
| Kaiser Mcare Advan | $46 | 142% |
| Sterling Mcr Adv-All Plans | $46 | 142% |
| Triwest - All Plans | $46 | 142% |
| Community Health Plan Mcaid-All Plans | $47 | 145% |
| Medicaid / KanCare | $47 | 145% |
| Molina Hlthcare Mcaid-All Plans | $47 | 145% |
| Wellcare Mcaid -All Other Plans | $47 | 145% |
| Wellpoint Mcaid - All Plans | $47 | 145% |
| Wellcare Mcr Adv | $50 | 154% |
| Idaho Dshs-All Plans | $54 | 167% |
| Kaiser - All Other Plans | $84 | 259% |
| Premera First - All Plans | $96 | 296% |
| Single Case Agree - All Plans | $96 | 296% |
| First Choice Admin | $108 | 333% |
| Admin Wsu Student-All Plans | $111 | 343% |
| Multiplan - All Plans | $111 | 343% |
| Asuris Nw Hlth-All Plans | $118 | 364% |
| Cigna | $118 | 364% |
| First Choice - All Other Plans | $118 | 364% |
| Focus Hlthcare - All Plans | $118 | 364% |
| Northwest One - All Plans | $118 | 364% |
| UnitedHealthcare | $118 | 364% |
| Aetna | $124 | 383% |
| Great West Hlth-All Plans | $124 | 383% |
| Integrated Hp - All Plans | $124 | 383% |
| Spokane Phco - All Plans | $124 | 383% |
| Provider Network Of America-All Plans | $128 | 395% |