CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Lewisgale Hospital Alleghany

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97530
  • Insurance Median: $35
  • Cash Discount Price: $290
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Lewisgale Hospital Alleghany is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.00x the Medicare baseline. Located in One Arh Lane - Po Box 7, Low Moor, VA.
Cash / Self-Pay
$290

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $290 (827%)
Insurance Median: $35 (100%)
Cash: $290 (827% of Medicare)
Ins. Median: $35 (100% 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.

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
Triatlantic $29 83%
Sentara Health $30 - $35 86%
United Mine Workers $30 - $35 86%
Devoted $30 - $35 86%
Aetna $30 - $157 86%
Humana $30 - $35 86%
United Behavioral Health $30 - $35 86%
United $30 - $130 86%
Good Samaritan Hospice $30 - $35 86%
Health Net $31 88%
Blue Cross Blue Shield $31 - $36 88%
Virginia Premier Health $31 - $35 88%
Cigna $32 - $36 91%
Clear Spring Health Plan $32 - $36 91%
Align Senior Care $33 - $37 94%
Lifeworks $55 157%
Universal Healthcare Group $64 182%
Virginia Health Network $102 - $206 291%
Greenbrier Sporting Club $105 299%
Greenvbrier Sporting Club $174 496%
Corvel $209 596%
Csx Hotels $232 662%
Occunet Workers Comp $232 662%
Health Payors Organization $246 701%
4Most $261 744%
Alleghany Highland Community $261 744%
Community Care Network $261 744%
C&O Employees Hospital Assn $261 744%
Multiplan $261 744%
One Health Plan $261 744%
American Postal Workers Union $261 744%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Arh Lane - Po Box 7, Low Moor, VA 24457
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals