CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Good Samaritan Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $45
Cash Discount Price: $627
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Good Samaritan Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $627. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.62x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$627

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $627 (2262%)

Insurance Median: $45 (162%)

Cash: $627 (2262% of Medicare)

Ins. Median: $45 (162% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$31 - $35	112%
Affinity Medical Group	$31 - $35	112%
Alignment Health Plan	$31 - $35	112%
Blue Cross Blue Shield	$31 - $35	112%
Blue Shield	$31 - $115	112%
Care1St Health Plan	$31 - $36	112%
Central Health Plan	$31 - $35	112%
Clever Care Of Golden State	$31 - $35	112%
Easy Choice Health Plan	$31 - $35	112%
Humana	$31 - $495	112%
Managed Health Network	$31 - $35	112%
On Lok Senior Health	$31 - $35	112%
Palo Alto Medical	$31 - $45	112%
Santa Clara Family Health Plan	$31 - $134	112%
Scan Health Plan	$31 - $35	112%
Triwest Healthcare Alliance	$31 - $35	112%
United	$31 - $180	112%
University Healthcare	$31 - $35	112%
Vitality Health Plan	$31 - $35	112%
Physicians Medical Group	$32	115%
Health Net	$34 - $165	123%
Corvel Corporation	$36 - $41	130%
Affinity Medical Group Comm	$40 - $45	144%
Canopy	$55 - $63	198%
Medcare Partners	$58 - $106	209%
Bright Health	$78 - $142	281%
Nx Health Network	$232 - $424	837%
Sutter Select	$232 - $424	837%
Multiplan	$251 - $566	905%
First Health	$294 - $707	1061%
Cigna	$309 - $566	1115%
Healthsmart	$309 - $601	1115%
Intercontinental Corporation	$309 - $566	1115%
Pha Pacific Health Alliance	$309 - $566	1115%
Ppo Next	$309 - $566	1115%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $627.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Good Samaritan Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.