CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Inspira Medical Center Vineland

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $40
Cash Discount Price: $150
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Inspira Medical Center Vineland is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.14x the Medicare baseline. Located in 1505 W Sherman Ave, Vineland, NJ.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $150 (428%)

Insurance Median: $40 (114%)

Cash: $150 (428% of Medicare)

Ins. Median: $40 (114% 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
UnitedHealthcare	$26 - $563	74%
Aetna	$29 - $77	83%
Fidelis Care Of Nj	$29	83%
Wellpoint	$29	83%
Braven Health	$38	108%
Clover Health	$38	108%
Horizon Nj Total Care	$38	108%
Medicare (plans)	$38	108%
Wellcare Dual Liberty	$38	108%
Wellpoint Full Dual Advantage	$38	108%
Healthspring	$39	111%
Humana	$39	111%
Jefferson Health Plan	$40	114%
Amerihealth	$45 - $54	128%
Blue Cross Blue Shield	$45 - $65	128%
Horizon Nj Health	$60	171%
Cigna	$61	174%
Ambetter / Centene	$77	220%
Oxford Health Plans	$228 - $563	650%

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 $150.
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 Inspira Medical Center Vineland 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.