CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Chino Valley Medical Center

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $34
Cash Discount Price: $34
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Chino Valley Medical Center is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.05x the Medicare baseline. Located in 5451 Walnut Ave, Chino, CA.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$32.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.4 (100%)

Cash / Self-Pay: $34 (105%)

Insurance Median: $34 (105%)

Cash: $34 (105% of Medicare)

Ins. Median: $34 (105% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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 Shield Of Promise	$5	15%
Molina	$5 - $34	15%
Traditional Medi-Cal	$5	15%
Vantage Care	$5 - $34	15%
Blue Cross Blue Shield	$6	19%
Health Net Of Ca	$6 - $50	19%
Inland Empire Health Plan	$8 - $43	25%
Rios	$33	102%
Alignment	$34	105%
Blue Shield Of Ca Triwest Healthcare Ccn	$34	105%
Central Health Plan	$34	105%
Choice Physicians Network	$34	105%
Citrus Valley Physicians Group	$34	105%
Emanate Health	$34 - $69	105%
Epic Health Plan	$34	105%
Inland Empire Foundation For Medical Care	$34	105%
Medicare (plans)	$34	105%
Prime Healthcare Services	$34	105%
Renal Payer Solutions	$34	105%
Tricare	$34	105%
Brand New Day	$35 - $51	108%
Neighborhood	$35	108%
Imperial Health Plan Of Ca	$36	111%
Health Net Federal Services Cdcr	$43	133%
Aetna	$44	136%
Worker Compensation	$45	139%
Employer Direct Healthcare	$48	148%
Naphcare	$53	164%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $34.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97535.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Chino Valley Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97535.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.