CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $55
- Cash Discount Price: $178
- vs. Medicare Baseline: 1.98x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at AHMC Anaheim Regional Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.98x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$178
Average discount available for prompt cash payment at this facility.
Insurance Median
$55
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: $178 (642%)
Insurance Median: $55 (198%)
Cash: $178 (642% of Medicare)
Ins. Median: $55 (198% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Veterans Administration | $21 | 76% |
| Ahmc Reciprocity Agreement | $22 - $71 | 79% |
| Allied Physicians | $22 - $46 | 79% |
| Altamed Health Network | $22 - $30 | 79% |
| Applecare Medical Group | $22 | 79% |
| Beverly Hospital | $22 - $34 | 79% |
| Brand New Day | $22 - $38 | 79% |
| Health Net | $22 | 79% |
| Healthcare Partners | $22 - $30 | 79% |
| Healthy Way La | $22 | 79% |
| Heritage Provider Network | $22 - $41 | 79% |
| Non Contracted Medi-Cal | $22 | 79% |
| Talbert Medical Group | $22 - $55 | 79% |
| Prospect Medical Group | $27 | 97% |
| Alta Los Angeles Hospital | $29 | 105% |
| Prospect Health Plan | $29 - $41 | 105% |
| Tricare | $29 | 105% |
| Aetna | $30 - $91 | 108% |
| Aids Health Foundation | $30 - $32 | 108% |
| Alignment Health Plan | $30 | 108% |
| Apa Aco Inc | $30 | 108% |
| Avanti | $30 - $37 | 108% |
| Blue Cross Blue Shield | $30 - $75 | 108% |
| Blue Shield Of California | $30 - $355 | 108% |
| California Health Plan | $30 | 108% |
| Caloptima | $30 - $40 | 108% |
| Central Health Of California | $30 | 108% |
| Davita Heatlhcare Partners Plan Inc | $30 - $129 | 108% |
| Healthnet | $30 | 108% |
| Humana | $30 | 108% |
| Kaiser Foundation Hospitals | $30 - $32 | 108% |
| Medicare (plans) | $30 - $119 | 108% |
| Monarch Health Plan | $30 - $162 | 108% |
| Pacificare | $30 | 108% |
| Scan Health Plan | $30 | 108% |
| Seoul Medical Group | $30 - $31 | 108% |
| Wellcare | $30 | 108% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $31 | 112% |
| Emanate Health | $31 - $38 | 112% |
| Innovative Integrated Health (Iih)/Orange County Pace | $31 | 112% |
| Monarch Healthcare Medical Group | $31 | 112% |
| Private Pay Flat Rate | $31 | 112% |
| Self-Pay | $31 | 112% |
| Align Senior Care | $32 | 115% |
| Health Net Inc | $32 - $183 | 115% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $32 | 115% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $32 | 115% |
| Hollywood Presbyterian Medpoint Mcal | $32 | 115% |
| Medi-Cal | $32 | 115% |
| Medical Safety Net Program | $32 | 115% |
| Nchp | $32 | 115% |
| Netcare Life And Health Insurance | $37 - $60 | 133% |
| Ahmc Health Self-Insurance Epo | $38 | 137% |
| Angels Baseball Workers Comp | $38 | 137% |
| Knox-Keene Act | $38 | 137% |
| Interplan | $40 - $167 | 144% |
| First Health | $43 - $202 | 155% |
| Orange County Preferred Provider Organization | $43 - $178 | 155% |
| Athens Administrators | $44 | 159% |
| Capp Care | $44 - $178 | 159% |
| Cigna | $44 - $530 | 159% |
| Corvel | $44 - $178 | 159% |
| Marriot Intl | $44 | 159% |
| Non Contracted Workers Comp | $44 | 159% |
| Advance Clinical Research Institute | $45 - $71 | 162% |
| Affiliated Doctors Of Orange County | $45 | 162% |
| Medical Acquisition Company | $60 - $95 | 216% |
| Msi/Medical Services For Indigents | $75 | 271% |
| Healthcare Partners Commercial | $80 - $129 | 289% |
| Huntington Memorial Hospital | $80 - $129 | 289% |
| Genesis Healthcare Ipa Ancillary | $89 - $143 | 321% |
| Memorial Healthcare Ipa | $100 | 361% |
| Affiliated Health Fund | $104 - $167 | 375% |
| Allnet Preferred Provider | $104 - $167 | 375% |
| Care First | $104 - $167 | 375% |
| Private Healthcare Systems | $104 - $167 | 375% |
| Choicecare | $112 - $178 | 404% |
| Multiplan Inc | $112 - $178 | 404% |
| National Provider Network | $119 - $190 | 429% |
| Three Rivers Providers Network | $119 - $190 | 429% |
| Health Payors Organization | $134 - $214 | 483% |
| Non Contracted Commercial | $149 - $238 | 538% |
| UnitedHealthcare | $198 - $344 | 714% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $1,403 | 5061% |