CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Lee County Community Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $31
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Lee County Community Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $30 (103%)
Insurance Median: $31 (107%)
Cash: $30 (103% of Medicare)
Ins. Median: $31 (107% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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
Aetna $29 - $132 100%
Ambetter / Centene $29 100%
Amerigroup $29 - $132 100%
Blue Cross Blue Shield $29 - $132 100%
Managed Medicaire $29 100%
Medicare (plans) $29 100%
Mountain Empire Pace $29 100%
Sentara Health $29 - $34 100%
United Mine Workers Of America $29 100%
UnitedHealthcare $29 - $132 100%
Cigna $30 - $132 103%
Devoted Health Plan $30 103%
Humana $30 103%
Molina Healthcare $30 - $67 103%
Nhc Advantage $30 103%
Optima Health $64 220%
Seven Corners, Inc. $70 241%
First Health Coventry $132 454%
Medcost $132 454%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

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