CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Community Memorial Hospital - Ventura

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $41
Cash Discount Price: $229
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Community Memorial Hospital - Ventura is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $229. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.48x the Medicare baseline. Located in 147 North Brent Street, Ventura, CA.

Cash / Self-Pay

$229

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $229 (826%)

Insurance Median: $41 (148%)

Cash: $229 (826% of Medicare)

Ins. Median: $41 (148% 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	$24 - $173	87%
Alignment Health Plan	$30	108%
Blue Cross Blue Shield	$30 - $41	108%
California Workers Compensation	$30	108%
Humana	$30	108%
Medicare (plans)	$30	108%
Non Contracted	$30 - $32	108%
Scan Health Plan	$30	108%
Seaview	$30	108%
Tricare	$30	108%
UnitedHealthcare	$30 - $420	108%
Wellcare Of California	$30	108%
Medi-Cal	$32	115%
Valley Care	$39 - $96	141%
Medicaid / KanCare	$47 - $134	170%
Gold Coast Health Plan	$48 - $134	173%
Ventura County Health Care Plan	$96	346%
Multiplan	$229	826%
Cigna	$290	1046%
Health Net Commercial	$382	1378%
Kaiser Commercial	$528	1905%
Blue Shield Epn	$578	2085%
Blue Shield Commercial	$626	2258%

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 $229.
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 Community Memorial Hospital - Ventura 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.