Occupational therapy (self-care training)
Facility: Northern Louisiana Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $246
- Cash Discount Price: $150
- vs. Medicare Baseline: 7.59x 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 759% of the Medicare baseline (a markup of 659%). 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 |
|---|---|---|
| UnitedHealthcare | $20 - $164 | 62% |
| Champus | $24 | 74% |
| Tricare | $24 - $29 | 74% |
| Champva | $24 | 74% |
| Medicare (plans) | $30 | 93% |
| Vantage Advantage | $30 | 93% |
| VA | $30 | 93% |
| Veterans Evaluation Svcs | $30 | 93% |
| Humana | $30 - $43 | 93% |
| Mutual of Omaha | $30 | 93% |
| Gulf South Services | $30 | 93% |
| Blue Cross Blue Shield | $30 - $66 | 93% |
| Aetna | $39 - $164 | 120% |
| Medicaid / KanCare | $39 - $273 | 120% |
| First Health | $48 - $232 | 148% |
| Vantage Health Plan Ppaca | $57 | 176% |
| Vantage Health Plan | $60 | 185% |
| Golden Rule Ins | $102 - $164 | 315% |
| Verity Healthnet | $134 | 414% |
| Cigna | $136 | 420% |
| Kaiser Permanente | $136 | 420% |
| Gilsbar | $150 | 463% |
| Self Pay | $150 | 463% |
| Geha | $218 - $259 | 673% |
| Multiplan | $232 | 716% |
| PHCS | $232 | 716% |
| Work Comp City of Ruston | $246 | 759% |
| Work Comp Nlmc Emp | $246 | 759% |
| Work Comp First Health | $246 | 759% |
| Workers Compensation | $246 | 759% |
| Aarp | $273 | 843% |
| Newera | $273 | 843% |
| Ima Insurance | $273 | 843% |
| The Hartford | $273 | 843% |
| Nalc Natl Assoc Ltr Carri | $273 | 843% |
| State Mutual Ins | $273 | 843% |
| Washington National Ins | $273 | 843% |
| Fox Everett Inc | $273 | 843% |
| Protective Life Ins | $273 | 843% |
| Apwu Health Plan | $273 | 843% |
| Gsu Athletics | $273 | 843% |
| Guarantee Trust Life Ins | $273 | 843% |
| United American | $273 | 843% |
| Nalc Health Benefit Plan | $273 | 843% |
| Gmp Employers Retiree Tru | $273 | 843% |
| Ltu Athletics | $273 | 843% |
| Crime Victims Compensatio | $273 | 843% |
| Ltu Student Ins Bollinger | $273 | 843% |
| Union Fidelity Life Ins | $273 | 843% |
| Specialty Hosp of Winnfie | $273 | 843% |
| Benefit Trust Life | $273 | 843% |
| American Life Accident | $273 | 843% |
| Premier Hospice | $273 | 843% |
| Lin Parish Detention | $273 | 843% |
| Industrial Accounts | $273 | 843% |
| Healthfirst Tpa | $273 | 843% |
| Sterling Investors Life | $273 | 843% |
| Ruston Regional Specialty | $273 | 843% |
| Physicians Mutual Ins | $273 | 843% |
| Misc Commercial | $273 | 843% |
| Mva Insurance Payors | $273 | 843% |
| Bankers Life and Casualty | $273 | 843% |
| Liberty Mutual Group | $273 | 843% |
| Nlmc Community Services | $273 | 843% |
| Liberty Healthshare | $273 | 843% |
| Aflc American Family Life | $273 | 843% |
| State Farm Insurance | $273 | 843% |
| Equitable | $273 | 843% |
| United Teachers Ins | $273 | 843% |
| Hospice of Caring Hearts | $273 | 843% |
| Us Dept of Labor | $273 | 843% |
| McR American Hlth Adv | $273 | 843% |
| Union Bankers Insurance C | $273 | 843% |
| Lifecare Specialty Hosp | $273 | 843% |
| Principal Mutual Life Ins | $273 | 843% |
| Lincoln Kidney Center | $273 | 843% |