CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Saint Agnes Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $95
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Saint Agnes Medical Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.43x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $87 (314%)
Insurance Median: $95 (343%)
Cash: $87 (314% of Medicare)
Ins. Median: $95 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
Correctcare Integrated Health $27 97%
Aetna $29 - $100 105%
Blue Cross Blue Shield $29 - $358 105%
Humana $29 - $30 105%
Medi-Cal Healthnet $29 - $34 105%
Medicare (plans) $29 - $30 105%
UnitedHealthcare $29 - $566 105%
Welbe Health $30 108%
Align Senior Care $34 123%
Kaiser Permanente $51 184%
Advantek Central Usd $66 238%
Blue Shield - Ca $69 - $358 249%
St Agnes Nicu Valley Childrens Hospital $87 314%
Healthnet $91 - $109 328%
Coventry $92 332%
Meritain $95 343%
Trustmark Small Business Benefits $95 343%
Allied Benefit Systems $100 361%
Boon Chapman $100 361%
Cba Network By Design $100 361%
Hap $100 361%
Network Health $100 361%
Webtpa $100 361%
Allegiance $103 372%
American Postal Workers Secondary $103 372%
Cigna $103 372%
Multiplan $113 408%
Phcs $113 408%
Interplan $121 437%
Blue Benefit Administrators Of Massachusetts $358 1291%
Blue Care Network $358 1291%
Blue Distinction Transplant $358 1291%
Blue Shield - Id (Regence) $358 1291%
Blue Shield - Ny Highmark Northeastern $358 1291%
Blue Shield - Ny Highmark Western $358 1291%
Blue Shield - Pa (Highmark) $358 1291%
Blue Shield - Wa (Regence) $358 1291%
Geha $558 2013%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals