CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Chino Valley Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $37
Cash Discount Price: $37
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Chino Valley Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.06x the Medicare baseline. Located in 5451 Walnut Ave, Chino, CA.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$35.07

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $35.07 (100%)

Cash / Self-Pay: $37 (106%)

Insurance Median: $37 (106%)

Cash: $37 (106% of Medicare)

Ins. Median: $37 (106% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $35.07 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	$16	46%
Molina	$16 - $37	46%
Traditional Medi-Cal	$16	46%
Vantage Care	$16 - $37	46%
Blue Cross Blue Shield	$17	48%
Health Net Of Ca	$17 - $54	48%
Inland Empire Health Plan	$23 - $47	66%
Rios	$35	100%
Alignment	$37	106%
Blue Shield Of Ca Triwest Healthcare Ccn	$37	106%
Central Health Plan	$37	106%
Choice Physicians Network	$37	106%
Citrus Valley Physicians Group	$37	106%
Emanate Health	$37 - $74	106%
Epic Health Plan	$37	106%
Inland Empire Foundation For Medical Care	$37	106%
Medicare (plans)	$37	106%
Prime Healthcare Services	$37	106%
Renal Payer Solutions	$37	106%
Tricare	$37	106%
Brand New Day	$38 - $56	108%
Neighborhood	$38	108%
Imperial Health Plan Of Ca	$39	111%
Health Net Federal Services Cdcr	$47	134%
Aetna	$48	137%
Worker Compensation	$49	140%
Employer Direct Healthcare	$52	148%
Naphcare	$58	165%

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 $37.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97530.

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 97530.
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.