CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Vibra Specialty Hospital of Portland

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $173
Cash Discount Price: $173
vs. Medicare Baseline: 4.93x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Vibra Specialty Hospital of Portland is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 4.93x the Medicare baseline. Located in 10300 Ne Hancock St, Portland, OR.

Cash / Self-Pay

$173

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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: $173 (493%)

Insurance Median: $173 (493%)

Cash: $173 (493% of Medicare)

Ins. Median: $173 (493% 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 493% of the Medicare baseline (a markup of 393%). 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
United_Healthcare	$123 - $222	351%
Americas_Choice_Provider_Network	$123 - $222	351%
Providence_Health_Plan	$123 - $222	351%
Williamette_Valley_Dr	$123 - $222	351%
Multiplan_Phcs_Network_Phcs_Savility_Healtheos_Network	$123 - $222	351%
Integrated_Health_Plan	$123 - $222	351%
Three_Rivers_Provider_Network	$123 - $222	351%
Providence_Health_Plan_Oregon_Health_Plan_Dr	$123 - $222	351%
Multiplan_Complimentary_Value_Point	$123 - $222	351%
Regence_Blue_Cross_Blue_Shield_Of_Or	$123 - $222	351%
Va_Administration	$123 - $222	351%
Aetna	$123 - $222	351%
Pacificsource	$123 - $222	351%
Workers_Comp	$123 - $222	351%
Medincrease	$123 - $222	351%
Independent_Medical_Systems	$123 - $222	351%
Washington_State_Dep_Of_L_And_I	$123 - $222	351%
Tricare	$123 - $222	351%
Three_Rivers_Auto	$123 - $222	351%

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 $173.
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 Vibra Specialty Hospital of Portland 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.