CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Banner Heart Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $89
Cash Discount Price: $28
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Banner Heart Hospital is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.21x the Medicare baseline. Located in 6750 East Baywood Avenue, Mesa, AZ.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $28 (101%)

Insurance Median: $89 (321%)

Cash: $28 (101% of Medicare)

Ins. Median: $89 (321% 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 321% of the Medicare baseline (a markup of 221%). 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
Arizona Physicians Ipa	$30	108%
Health Net	$30 - $91	108%
Mercy Care	$30	108%
Aetna	$34 - $98	123%
Health Choice Arizona, Inc.	$51 - $84	184%
Hospice Of The Valley	$59	213%
Arizona Priority Care	$68	245%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$76	274%
Plotkin Health	$76	274%
Oscar Health Plan	$84	303%
Quiktrip Corporation	$91	328%
Blue Cross Blue Shield	$92 - $123	332%
Arizona Medical Network	$118	426%
Provider Network Of America	$127	458%
Cigna	$203 - $225	732%
UnitedHealthcare	$241 - $265	869%

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 $28.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner Heart Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
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.