CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Grandview Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $176
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 6.35x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Grandview Medical Center is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 6.35x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$176

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $84 (303%)
Insurance Median: $176 (635%)
Cash: $84 (303% of Medicare)
Ins. Median: $176 (635% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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 635% of the Medicare baseline (a markup of 535%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Tricare $24 87%
Node Champva $25 90%
Veterans Eval Services $25 90%
Aetna $26 - $122 94%
Blue Advantage $26 94%
Cigna $26 - $171 94%
Hospice $26 94%
Humana $26 94%
Medicare (plans) $26 94%
Node Clover Health Mcr Adv $26 94%
Node Devoted Health Mcr Adv $26 94%
Node Va $26 94%
Node Wellcare Mcr Adv $26 94%
Select Health $26 94%
UnitedHealthcare $26 - $217 94%
Victory Health $26 94%
Viva Health $26 - $191 94%
Medicaid / KanCare $28 101%
Alamed $29 105%
First Health $34 - $263 123%
Novanet $35 126%
Ambetter / Centene $39 141%
Node Us Dept Of Labor $39 141%
Healthspring $45 162%
Self Pay $64 - $105 231%
Blue Cross Blue Shield $67 242%
Bp Health Advocate $107 - $110 386%
Ag Administrators $150 - $154 541%
Choicecare $150 - $154 541%
Drummond $150 - $154 541%
American Employee Alliance $172 - $176 620%
Healthchoice $214 - $263 772%
Value Options $214 - $220 772%
Multiplan $262 - $307 945%
Blue Bell Creameries $300 - $307 1082%
Natl Comp Care $322 - $329 1162%
Usa Ppo $322 - $329 1162%
Coventry Work Comp Al $335 - $343 1209%
Alabama Wc $365 - $373 1317%
Cal-Med $365 - $373 1317%
Corvel $365 - $373 1317%
Associated Admin $386 - $395 1392%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals