CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Banner Payson Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $37
Cash Discount Price: $11
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Banner Payson Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.33x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.

Cash / Self-Pay

$11

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $11 (40%)

Insurance Median: $37 (133%)

Cash: $11 (40% of Medicare)

Ins. Median: $37 (133% 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.

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	$20 - $34	72%
Health Net	$20 - $50	72%
Mercy Care	$20 - $34	72%
Aetna	$34 - $81	123%
Banner Health	$34	123%
Banner University Health Plan	$34	123%
Blue Cross Blue Shield	$34 - $151	123%
Care 1St	$34	123%
Cigna	$34 - $66	123%
Gila River Health Care Corporation	$34	123%
Health Choice Arizona, Inc.	$34 - $49	123%
Kaiser Foundation Health Plan	$34	123%
Triwest Healthcare Alliance Corp - Va Ccn	$34	123%
UnitedHealthcare	$34 - $56	123%
Upmc Health Plan	$34	123%
Wellpoint	$34	123%
Carelon	$36	130%
Humana	$36	130%
Arizona Priority Care	$37	133%
Devoted Health Services	$37	133%
Gold Kidney Health Plan	$37	133%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$37	133%
Plotkin Health	$37	133%
Oscar Health Plan	$56	202%
Quiktrip Corporation	$58	209%
Arizona Medical Network	$75	271%
Provider Network Of America	$75	271%

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 $11.
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 Payson Medical Center 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.