CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Loma Linda University Medical Center-Murrieta

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $98
Cash Discount Price: $63
vs. Medicare Baseline: 2.79x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Loma Linda University Medical Center-Murrieta is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 2.79x the Medicare baseline. Located in 28062 Baxter Road, Murrieta, CA.

Cash / Self-Pay

$63

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $63 (180%)

Insurance Median: $98 (279%)

Cash: $63 (180% of Medicare)

Ins. Median: $98 (279% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 279% of the Medicare baseline (a markup of 179%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Inland Empire Health Plan (Iehp)	$18	51%
Kaiser Foundation Hospitals	$25 - $67	71%
Adventist Health	$28 - $57	80%
Lluh Dept Of Risk Management	$35	100%
Aetna	$75 - $96	214%
Alpha Care Medical Group	$77 - $119	220%
Heritage Provider Network	$87 - $95	248%
Cigna	$91	259%
Epic Health Plan	$91	259%
Molina Healthcare Of Ca	$98	279%
Trivalley Medical Group	$100	285%
Multiplan	$105	299%
Dignity Health	$119	339%
Vantage Medical Group	$119	339%
UnitedHealthcare	$220 - $261	627%
Blue Shield Of California	$284 - $354	810%
Blue Cross Blue Shield	$334	952%

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 $63.
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 Loma Linda University Medical Center-Murrieta 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.