CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Lee County Community Hospital

Billing Code: 97535 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$46
about 1.4× the $32 Medicare rate · typically $31–$71
modeled estimate · not a bill or quote
What this hospital charges insurers
$51
About the fair price
about $5 over the fair price · 1.6× Medicare
Medicare pays $32 Fair price $46 This hospital $51 Cash price $33 Hospital's list price $144

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

Highest price of the 9 VA hospitals we have prices for — worth calling around.

Cheapest $23 Priciest $51

Black dot = this hospital, among the 9 VA hospitals with a price for this procedure. Full list below.

A fair price for a Occupational therapy (self-care training) is about $46 (about 1.4× the $32 Medicare rate). Lee County Community Hospital charges insurers about $51, or about $33 in cash — about the fair price. Located in Pennington Gap, VA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $32 - $144 99%
Blue Cross Blue Shieldmajor $32 - $144 99%
Aetnamajor $32 - $144 99%
Cignamajor $33 - $144 102%
Humanamajor $32 99%
Ambetter (Centene) $32 99%
Amerigroup $32 - $144 99%
Devoted Health $33 102%
Molina $33 - $53 102%
Sentara $32 - $51 99%
+ 4 smaller / regional plans $32 - $76
Government programs also on file: Medicare.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 127 Health Care Drive, Pennington Gap, VA 24277
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals