CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Good Shepherd Rehabilitation Hospital

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $41
Cash Discount Price: $33
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Good Shepherd Rehabilitation Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.17x the Medicare baseline. Located in 3200 Center Valley Parkway, Center Valley, PA.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $33 (94%)

Insurance Median: $41 (117%)

Cash: $33 (94% of Medicare)

Ins. Median: $41 (117% 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
Lehigh Valley Health Network	$20	57%
Multiplan	$23	66%
Prime Health	$23	66%
Blue Cross Blue Shield	$29 - $115	83%
Devon Health	$30	86%
Humana	$31 - $33	88%
Geisinger	$32 - $44	91%
Amerihealth Caritas PA	$33 - $44	94%
Choice Care	$33	94%
Cigna	$33 - $148	94%
Clover Health	$33	94%
Everyday Life	$33	94%
Highmark Wholecare	$33 - $49	94%
Keystone First	$33 - $44	94%
Medicare (plans)	$33	94%
PA Health and Wellness	$33 - $36	94%
UPMC	$34 - $53	97%
Aetna	$51 - $144	145%
Highmark	$60	171%
UnitedHealthcare	$79	225%
Amerihealth	$115	328%

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 $33.
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 Good Shepherd Rehabilitation Hospital 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.