CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Uc San Diego Health Hillcrest - Hillcrest Med Ctr
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $155
- Cash Discount Price: $174
- vs. Medicare Baseline: 5.59x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Uc San Diego Health Hillcrest - Hillcrest Med Ctr is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.59x the Medicare baseline. Located in 200 West Arbor Drive, San Diego, CA.
Cash / Self-Pay
$174
Average discount available for prompt cash payment at this facility.
Insurance Median
$155
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: $174 (628%)
Insurance Median: $155 (559%)
Cash: $174 (628% of Medicare)
Ins. Median: $155 (559% 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 559% of the Medicare baseline (a markup of 459%). 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 |
|---|---|---|
| Champva [1020] | $30 | 108% |
| Mid County Physicians Med Grp [1054] | $30 | 108% |
| Alameda Alliance For Health [2027] | $32 | 115% |
| Alignment Health Plan [2020] | $32 | 115% |
| Alternate Medi-Cal [2001] | $32 | 115% |
| Blue Cross Blue Shield | $32 - $185 | 115% |
| Brand New Day [1089] | $32 | 115% |
| California Department Of Public Health [1237] | $32 | 115% |
| California Health & Wellness Medi-Cal [1122] | $32 | 115% |
| Caremore [2028] | $32 | 115% |
| Cms - County Medical Services [1025] | $32 - $205 | 115% |
| Community Care Ipa [1131] | $32 | 115% |
| Community Eldercare [1027] | $32 | 115% |
| Federal Prison [1031] | $32 | 115% |
| Gold Coast Health Plan [2031] | $32 | 115% |
| Health Plan Of San Joaquin [2032] | $32 | 115% |
| Hemet Community Med Grp - Promisecare [1040] | $32 | 115% |
| Imperial Health Holdings [1132] | $32 | 115% |
| Kern Health Systems [2033] | $32 | 115% |
| La Care Health Plan [2025] | $32 | 115% |
| Medi-Cal [1048] | $32 | 115% |
| Medicaid / KanCare | $32 | 115% |
| Regal Mg 'Heritage Provider Network' [2019] | $32 | 115% |
| San Diego County [1071] | $32 - $158 | 115% |
| Sd Physicians Med Grp [1076] | $32 - $205 | 115% |
| State Of California [1082] | $32 | 115% |
| UnitedHealthcare | $32 - $379 | 115% |
| Unlisted Mcal Hmo Non-Contract [1049] | $32 | 115% |
| Vantage [1092] | $32 - $190 | 115% |
| Ximed [2016] | $32 | 115% |
| Blue Shield Promise [1017] | $37 | 133% |
| Aetna | $38 - $138 | 137% |
| Cigna | $38 - $190 | 137% |
| Humana | $38 - $269 | 137% |
| Mc Blue Shield Generic Payor [164016] | $38 | 137% |
| Mc Blue Shield Hmo [164015] | $38 | 137% |
| Mc Brand New Day Generic Payor [164031] | $38 | 137% |
| Mc Brand New Day Hmo [164030] | $38 | 137% |
| Mc Healthnet Generic Payor [164010] | $38 | 137% |
| Mc Healthnet Hmo [164004] | $38 | 137% |
| Mc Hnet Blue&Gold Aco [164017] | $38 | 137% |
| Mc Scan Generic Payor [164034] | $38 | 137% |
| Mc Scan Hmo [164035] | $38 | 137% |
| Uc Aff Blue Shield Sr/Sdsm [164037] | $38 | 137% |
| Alternate Molina [1240] | $40 | 144% |
| Molina [1055] | $40 | 144% |
| Community Health Group [1022] | $41 | 148% |
| Health Net [1039] | $43 - $888 | 155% |
| Inland Empire Health Plan Transplant [1126] | $45 | 162% |
| Inland Empire Health Plan [1121] | $45 | 162% |
| Cal Optima [1016] | $46 | 166% |
| Padres Workers Compensation [2013] | $51 | 184% |
| Padres [2014] | $51 | 184% |
| Ucr Prompt Pay Payor [8240] | $64 | 231% |
| Multicultural Med Grp [1057] | $115 | 415% |
| Alternate Scan Health [2088] | $126 | 455% |
| Elizabeth Hospice [2018] | $126 | 455% |
| Scan Health [1072] | $126 | 455% |
| Blue Shield [1014] | $134 - $321 | 483% |
| Olympus Managed Healthcare Inc [1102] | $138 | 498% |
| Alternate Healthnet [1007] | $152 - $316 | 548% |
| Usoc - Us Olympic Committee [1123] | $156 | 563% |
| Global Excel [1036] | $158 | 570% |
| Sharp Health Plan [1079] | $158 - $207 | 570% |
| Alternate Sheriff Custody [1106] | $205 | 740% |
| Arch Health Partners [2000] | $205 | 740% |
| Axa Assistance [1098] | $205 | 740% |
| Cassidy Med Grp [1019] | $205 | 740% |
| Cmn - Canadian Medical Network [1024] | $205 | 740% |
| Ets - Lifetrac Network [1103] | $205 | 740% |
| Health Net Bh (Mhn) [1038] | $205 | 740% |
| Health Net Bh (Mhn) [2010] | $205 | 740% |
| Interlink Health Services Transplant [1124] | $205 | 740% |
| Interlink Health Transplant [2085] | $205 | 740% |
| Mgm Resorts [1053] | $205 | 740% |
| National Healthcare Solutions Inc [1100] | $205 | 740% |
| Quality Health [1069] | $205 | 740% |
| San Diego County Sheriff Custody [2012] | $205 | 740% |
| Scripps Coastal Med Grp [1074] | $205 | 740% |
| Tri-City [1085] | $205 | 740% |
| Graybill Med Grp [1037] | $207 | 747% |
| Sharp Community Med Grp [1078] | $207 | 747% |
| Sharp Rees Stealy [1080] | $207 | 747% |
| Kaiser [1046] | $212 | 765% |
| Alternate Health Net Bh [2059] | $215 | 776% |
| Embassy Sponsored [1101] | $215 - $221 | 776% |
| Healthnet Transplants [1114] | $215 | 776% |
| Interplan [1045] | $221 | 797% |
| Mercy Physicians Med Grp [1052] | $221 | 797% |
| Pacific Foundation [1063] | $221 | 797% |
| Beech Street [1012] | $237 | 855% |
| First Health [1032] | $237 | 855% |
| Admar [1001] | $243 | 877% |
| Bps - Benefit Plan Services [1015] | $243 | 877% |
| Multiplan [1058] | $243 | 877% |
| Private Healthcare Systems [1067] | $243 - $316 | 877% |
| Carnival Cruises [1018] | $253 | 913% |
| Alternate Kaiser Rad Onc [2089] | $316 | 1140% |
| Chargers Football Company [1109] | $316 | 1140% |
| Alternate Blue Shield [2002] | $321 | 1158% |
| Blue Shield Transplants [1113] | $321 | 1158% |
| Palomar Health [1128] | $379 | 1367% |
| Easy Choice [1029] | $395 | 1425% |
| Sharp Healthcare Transplant [1119] | $427 | 1540% |