CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: San Antonio Regional Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $243
  • Cash Discount Price: $249
  • vs. Medicare Baseline: 8.77x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at San Antonio Regional Hospital is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 8.77x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$249

Average discount available for prompt cash payment at this facility.

Insurance Median
$243

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: $249 (898%)
Insurance Median: $243 (877%)
Cash: $249 (898% of Medicare)
Ins. Median: $243 (877% 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 877% of the Medicare baseline (a markup of 777%). 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
Blue Shield Mcr Adv $29 105%
Caremore Mcr Adv - All Plans $29 105%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $29 105%
Healthnet Mcr Adv $29 105%
Humana $29 105%
Iehp Mcr Adv $29 105%
Inter Valley Hp Mcr Adv- All Plans $29 105%
Kindred Mcr Adv-All Plans $29 105%
Molina Mcr Adv $29 105%
Scan Health Plan Mcr Adv-All Plans $29 105%
Tricare $29 105%
Universal Care - All Plans $29 105%
Blue Cross Blue Shield $30 - $360 108%
Kasiser Mcr Adv $31 112%
Zelis Mcr Adv $31 112%
Imperial Health Mcr Adv-All Plans $32 115%
Medi-Cal $32 115%
Kaiser Medi-Cal $33 119%
Healthnet Medi-Cal $34 123%
Alpha Care Mg Mcal/Hlthy Kids $35 126%
Heritage Prov Ntwrk/Regal Mcal $35 126%
Choice Phycn Ntwrk Op Only $36 130%
Molina Medi-Cal $37 133%
Molina Exchange-All Other Plans $38 137%
Aetna $39 - $411 141%
Iehp Mcal $41 148%
Iehp Comm - All Other Plans $42 152%
Redlands Employee $44 159%
Redlands Hmo-All Other Plans $46 166%
Prime Health - All Plans $51 184%
Blue Shield Epn $67 242%
Healthnet - All Other Plans $70 253%
Ambetter / Centene $71 - $75 256%
Kaiser Comm - All Other Plans $81 292%
Epic Health Plan - All Other Plans $117 - $123 422%
Coventry Ccn/First Hlth - All Plans $120 433%
UnitedHealthcare $148 - $270 534%
Pc Inland Valley Scan $195 - $206 703%
Pc Inland Valley-All Other Plans $195 - $206 703%
Blue Shield Epo Ppo - All Other Plans $244 880%
Blue Shield Hmo Pos / Calpers Ppo $244 880%
Choicecare Ntwrk-All Plans $281 - $296 1014%
Multiplan/Phcs - All Plans $281 - $296 1014%
Networks By Design - All Plans $292 - $308 1053%
Zelis Comm-All Other Plans $292 - $308 1053%
Foundation Inland Epo-All Other Plans $312 - $329 1126%
Foundation Inland Ppo $332 - $349 1198%
Health Payors - All Plans $351 - $370 1266%
Interplan - All Plans $351 - $370 1266%
Wellcare/Easy Choice-All Plans $382 - $403 1378%
Alpha Care Mg Mcr Adv $390 - $411 1407%
Central Hlth Plan Mcr Adv-All Plans $390 - $411 1407%
Epic Health Plan Mcr Adv $390 - $411 1407%
Prospect Hp-All Plans $390 - $411 1407%
Providence Clevercare Mcr Adv $390 - $411 1407%
Heritage Prov Ntwrk/Regal Mcr Adv $396 - $417 1429%
Clever Care Mcr Adv - All Plans $410 - $432 1479%
La Salle Hp Mcr Adv-All Plans $410 - $432 1479%
Alpha Care Mg-All Other Plans $488 - $514 1760%
Providence Oscar-All Other Plans $566 - $596 2042%
Cigna $599 2161%
Heritage Prov Ntwrk/Regal - All Other Plans $717 - $755 2587%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals