Occupational therapy (self-care training)
Facility: University Medical Center
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $131
- Cash Discount Price: $104
- vs. Medicare Baseline: 4.04x 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 404% of the Medicare baseline (a markup of 304%). 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 |
|---|---|---|
| Aig | $19 - $163 | 59% |
| Cement Masons & Plasters H&W | $19 - $147 | 59% |
| Beech Street | $19 - $163 | 59% |
| Kaiser | $27 - $84 | 83% |
| City of North Las Vegas | $27 - $147 | 83% |
| National Security Technologies | $27 - $84 | 83% |
| Cirque De Soleil | $27 - $84 | 83% |
| Great West Healthcare | $27 - $84 | 83% |
| Cigna | $27 - $84 | 83% |
| Las Vegas Firefighters 1285 | $30 - $147 | 93% |
| American Postal Workers Health Plan | $30 - $323 | 93% |
| UnitedHealthcare | $30 - $323 | 93% |
| Surest | $30 - $323 | 93% |
| Switch | $30 - $147 | 93% |
| Sierra Health and Life | $31 - $202 | 96% |
| Ambetter / Centene | $31 - $185 | 96% |
| Molina | $31 - $185 | 96% |
| Blue Cross Blue Shield | $31 - $84 | 96% |
| So Ca Pipe Trades H&W | $37 - $84 | 114% |
| Teamsters Local 14 | $37 - $147 | 114% |
| Ufcw Local 711 Retail Clerks | $37 - $147 | 114% |
| Operating Engineers | $37 - $147 | 114% |
| Teamsters Local 631 | $37 - $147 | 114% |
| Laborers Health and Welfare | $37 - $147 | 114% |
| Southwest Carpenters H&W | $37 - $84 | 114% |
| Plumbers & Pipefitters Loc 525 | $37 - $147 | 114% |
| Sheet Metal Workers | $37 - $84 | 114% |
| California Ironwork Field Welfare | $37 - $84 | 114% |
| Caesar's Entertainment | $37 - $147 | 114% |
| Boyd Group | $37 - $147 | 114% |
| Teamsters Local 986 | $37 - $147 | 114% |
| Bricklayers Local 13 | $37 - $147 | 114% |
| Electrical Workers | $37 - $147 | 114% |
| Aetna | $50 - $151 | 154% |
| Nevada Energy | $55 | 170% |
| Coventry | $55 | 170% |
| Mail Handlers Benefit Plan | $55 | 170% |
| First Health | $64 | 198% |
| Three Rivers Provider Network | $64 | 198% |
| Health Net | $64 - $286 | 198% |
| Advantra Freedom | $84 | 259% |
| Alignment Health | $101 | 312% |
| Scan | $101 | 312% |
| Clark County Detention Center | $101 | 312% |
| Laughlin Coalition | $131 | 404% |
| Las Vegas Metro Police Dept | $147 | 454% |
| Clark County EPO | $147 | 454% |
| Nevada Hand | $147 | 454% |
| Mirage Las Vegas | $147 | 454% |
| Wynn Resorts | $147 | 454% |
| Mgm Grand | $147 | 454% |
| Resorts World Las Vegas | $147 | 454% |
| Culinary Workers Hwf | $147 | 454% |
| Employee Painters Trust | $147 | 454% |
| Clark County Self Funded | $147 | 454% |
| City of Henderson | $147 | 454% |
| Clark County Firefighters 1908 | $147 | 454% |
| Venetian/Palazzo | $153 | 472% |
| Golden Nugget Hotel & Casino | $153 | 472% |
| Golden Entertainment | $153 | 472% |
| P3 Health Partners | $153 | 472% |
| Dignity Health | $153 | 472% |
| Pli Las Vegas | $153 | 472% |
| Teacher's Health Trust | $153 | 472% |
| Marshall Retail Group | $153 | 472% |
| Truline Corporation | $153 | 472% |
| Arroweye Solutions | $153 | 472% |
| Stations Casinos | $153 | 472% |
| State of Nevada | $153 | 472% |
| Rebel Oil Company | $153 | 472% |
| Health Direct Partners | $185 | 571% |
| Selecthealth | $185 | 571% |
| Nevada Preferred Professionals | $202 | 623% |
| Zuffa | $202 | 623% |
| Universal Health Network (Uhn) | $202 | 623% |
| Prominence Health Plan | $202 | 623% |
| Jw Marriott | $202 | 623% |
| One Health Plan | $243 | 750% |
| Hometown Health Plan of Nevada | $243 | 750% |
| VA Pc3 (VA Choice) | $302 | 932% |
| Las Vegas Sand Corps | $323 | 997% |