Occupational therapy (self-care training)
Facility: Atlanticare Regional Medical Center - City Campus
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $159
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.91x 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 491% of the Medicare baseline (a markup of 391%). 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 |
|---|---|---|
| Americhoice | $26 - $28 | 80% |
| UnitedHealthcare | $26 - $153 | 80% |
| Wellcare | $27 - $30 | 83% |
| Horizon | $28 - $151 | 86% |
| Self Pay | $30 - $32 | 93% |
| Devoted Health Plan | $43 | 133% |
| Amerigroup | $52 - $56 | 160% |
| Global Exchange Managed Care | $62 | 191% |
| Magnacare | $80 - $194 | 247% |
| Health Partners Plan | $83 | 256% |
| Cigna | $84 - $109 | 259% |
| Aetna | $96 - $162 | 296% |
| Evernorth | $100 - $108 | 309% |
| Qualcare Commercial | $100 - $108 | 309% |
| Great West Life | $100 - $109 | 309% |
| Amerihealth | $128 - $182 | 395% |
| First McO | $129 - $140 | 398% |
| Mutual of Omaha | $129 - $140 | 398% |
| Active Care Plus | $129 - $140 | 398% |
| Qualcare Wc | $129 - $140 | 398% |
| Donio Trucking | $139 - $151 | 429% |
| Consumer Health Network (Chn) | $139 - $194 | 429% |
| Devon/ Ullicare | $149 - $162 | 460% |
| Oxford | $149 - $162 | 460% |
| Coventry Health Care | $159 - $173 | 491% |
| Private Healthcare System (PHCS) | $159 - $173 | 491% |
| Blue Cross Blue Shield | $164 - $178 | 506% |
| Metrahealth of Nj | $169 - $184 | 522% |
| Health South | $169 - $184 | 522% |
| Three Rivers Provider Network (Trpn) | $169 - $184 | 522% |
| Health Payors Org | $169 - $184 | 522% |
| Prime Health Services | $169 - $184 | 522% |
| Active Care Nj Pip | $179 - $194 | 552% |
| Beech Street | $179 - $194 | 552% |
| Department of Corrections | $179 - $194 | 552% |
| McS Commercial | $179 - $194 | 552% |
| Choice Care | $179 - $194 | 552% |
| Metracomp | $179 - $194 | 552% |
| Provider Select, Inc | $179 - $194 | 552% |
| Health Network Inc | $179 - $194 | 552% |
| Intergroup Preferred Program | $179 - $194 | 552% |
| Multiplan | $179 - $194 | 552% |
| Galaxy Health Network | $179 - $194 | 552% |
| Master Care Inc | $184 - $200 | 568% |
| Atlantis Health Plan | $184 - $200 | 568% |
| Advance Healthcare System | $189 - $205 | 583% |
| National Health Plan | $189 - $205 | 583% |
| Community Care Network | $189 - $205 | 583% |
| Health Network America | $189 - $205 | 583% |
| McSi/Mrsi No Fault | $189 - $205 | 583% |
| McSi/Mrsi Worker's Comp | $189 - $205 | 583% |