CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: AHMC Seton Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $43
  • Cash Discount Price: $148
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at AHMC Seton Medical Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.55x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$148

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $148 (534%)
Insurance Median: $43 (155%)
Cash: $148 (534% of Medicare)
Ins. Median: $43 (155% 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.

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
Medi-Cal $22 79%
Veterans Administration (Va) $24 87%
San Mateo County/San Mateo County General Hospital $27 97%
Self Pay $28 - $63 101%
North East Medical Services $31 - $34 112%
San Francisco Health Plan $31 112%
Cmac $32 115%
Hill Physicians Medical Group Inc $32 - $38 115%
Kaiser $32 - $152 115%
Blue Cross Blue Shield $33 - $141 119%
Jade Health Care Mg $33 - $34 119%
Aetna $34 - $124 123%
Apcmg $34 - $51 123%
Asian American Medical Group $34 - $43 123%
Blue Shield Of California $34 - $214 123%
Brand New Day $34 - $43 123%
Brown And Toland Medical Group $34 - $43 123%
Canopy Health $34 - $62 123%
Care Advantage $34 123%
Chinese Community Health Plan $34 - $92 123%
Covid-19 Uninsured Program $34 123%
For Your Benefit $34 123%
Healthnet Seniority $34 123%
Humana $34 123%
Imperial Health Plan $34 123%
Medicare (plans) $34 123%
Pacificare $34 123%
Tricare $34 123%
UnitedHealthcare $34 - $796 123%
Easy Choice Hospital Services $35 126%
Central Health Plan $36 130%
Health Plan Of San Mateo Healthworx $39 141%
Ahmc Health $43 155%
Knox-Keene Act $43 155%
Athens Administrators $44 159%
Corvel Healthcare $44 159%
Multiplan/Bce Emergis $44 - $139 159%
Work Comp Other $44 159%
Health Plan Of San Mateo $45 162%
Interplan Corporation $111 400%
Cigna $130 469%
Healthcare Foundation Of San Mateo $130 - $139 469%
Private Healthcare Sytems Inc $139 501%
The First Health Network $139 501%
Health Net $142 512%
Beech Street Corporation $148 534%
Choicecare Network $157 566%
Multiplan $157 566%
Mills Peninsula Health Services $166 599%
Indemnity $185 667%
Workers Compensation Federal $185 667%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals