CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Clovis Community Medical Center
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $29
- Cash Discount Price: $163
- vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Clovis Community Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.05x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$163
Average discount available for prompt cash payment at this facility.
Insurance Median
$29
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: $163 (588%)
Insurance Median: $29 (105%)
Cash: $163 (588% of Medicare)
Ins. Median: $29 (105% 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 |
|---|---|---|
| Blue Cross Blue Shield | $22 - $130 | 79% |
| Blue Shield | $22 - $408 | 79% |
| Cal Caloptima | $22 | 79% |
| Ccs Fresno | $22 | 79% |
| Ccs Kern | $22 | 79% |
| Ccs Kings | $22 | 79% |
| Ccs Madera/Sacramento | $22 | 79% |
| Ccs Mariposa | $22 | 79% |
| Ccs Merced | $22 | 79% |
| Ccs Stanislaus | $22 | 79% |
| Ccs Tulare | $22 | 79% |
| Chdp | $22 | 79% |
| Fresno County Funded Specialty Care | $22 | 79% |
| Generic Care Out Of County | $22 | 79% |
| Generic Ccs Other Counties | $22 | 79% |
| Genetically Handicapped Person | $22 | 79% |
| Gold Coast Medi-Cal | $22 | 79% |
| Medi-Cal Alameda Alliance For Health | $22 | 79% |
| Medi-Cal Blue Shield Promise Health | $22 | 79% |
| Medi-Cal California Health & Wellness Plan | $22 | 79% |
| Medi-Cal Cencal Health | $22 | 79% |
| Medi-Cal Community Health Group | $22 | 79% |
| Medi-Cal Contra Costa Health Plan | $22 | 79% |
| Medi-Cal Health Plan Of San Mateo | $22 | 79% |
| Medi-Cal Inland Empire Health | $22 | 79% |
| Medi-Cal Kern Family Health | $22 | 79% |
| Medi-Cal La Care Health | $22 | 79% |
| Medi-Cal Molina | $22 | 79% |
| Medi-Cal Partnership Health Plan Of Ca | $22 | 79% |
| San Francisco Health Plan Medi-Cal | $22 | 79% |
| Santa Clara Family Health Plan - Premier Health | $22 | 79% |
| Santa Clara Family Health Plan - Valley Health | $22 | 79% |
| Advantek Table Mountain Rancheria Tribal Member | $29 | 105% |
| Aetna | $29 - $102 | 105% |
| Blue Shield 65 Plus Hmo Ehs | $29 | 105% |
| Blue Shield 65 Plus Hmo First Choice | $29 | 105% |
| Blue Shield Hmo-Cvmp/Medpro | $29 | 105% |
| Blue Shield Promise - Imperial | $29 | 105% |
| Blue Shield Saint Agnes | $29 | 105% |
| Blue Shield Sante | $29 | 105% |
| Brand New Day | $29 | 105% |
| Bscphp - Dhmso | $29 | 105% |
| Bscphp - First Choice | $29 | 105% |
| Bscphp Hmo - First Choice | $29 | 105% |
| Care1St Hmo - Ehs | $29 | 105% |
| Cares Act Provider Relief Fund | $29 | 105% |
| Cigna | $29 - $419 | 105% |
| Gemcare Hmo | $29 | 105% |
| Generic | $29 | 105% |
| Generic Bscphp | $29 | 105% |
| Generic Victims Of Crime | $29 | 105% |
| Hartford Life Supplement | $29 | 105% |
| Healthnet Hmo - Cvmp/Medpro | $29 | 105% |
| Healthnet Hmo - Dhmso | $29 | 105% |
| Healthnet Hmo - La Salle | $29 | 105% |
| Healthnet Hmo - Sante | $29 | 105% |
| Healthnet Sante | $29 | 105% |
| Healthnet Sante - Sub Cap Dual Risk | $29 | 105% |
| Healthnet Sante Dual Risk | $29 | 105% |
| Humana | $29 - $173 | 105% |
| Kaiser | $29 | 105% |
| Medi-Cal Innovative Integrated Health | $29 | 105% |
| Medicare (plans) | $29 | 105% |
| Meritage Blue Shield 65 Plus | $29 | 105% |
| Meritage Brand New Day | $29 | 105% |
| Meritage Healthnet Hmo | $29 | 105% |
| Railroad Part A | $29 | 105% |
| Railroad Part A & B | $29 | 105% |
| Railroad Part B | $29 | 105% |
| Sante | $29 - $34 | 105% |
| Sante Sub Cap Healthnet Seniority | $29 | 105% |
| Sante Sub Cap-Blue Shield/Sante | $29 | 105% |
| Sante-Blue Shield/Sante | $29 | 105% |
| Sante-Healthnet Seniority | $29 | 105% |
| Sante-Sub Cap Ma Brand New Day | $29 | 105% |
| Scan Health Plan | $29 | 105% |
| Sequoia Pace - Peak Tpa | $29 | 105% |
| Todays Pyramid | $29 | 105% |
| UnitedHealthcare | $29 - $590 | 105% |
| Us Marshal | $29 | 105% |
| Victims Of Crime | $29 | 105% |
| Well Path (Cfmg) | $29 - $224 | 105% |
| Wellcare | $29 | 105% |
| Alignment Health Plan | $32 | 115% |
| Champion Health Plan Of California Ma | $32 | 115% |
| Innovative Integrated Health Community Plans Hmo | $32 | 115% |
| Health Plan Of San Joaquin | $33 | 119% |
| Imperial Health Plan Hmo | $33 | 119% |
| Sequoia Pace | $33 | 119% |
| Adventist -Mcl Calviva Sub Cap | $37 | 133% |
| Correctcare Integrated Health | $38 | 137% |
| Healthnet | $43 - $372 | 155% |
| Central Valley Medical Providers | $51 - $143 | 184% |
| Community Care | $52 | 188% |
| Coalinga State Hospital | $58 | 209% |
| Naphcare Inc-Mendota | $62 | 224% |
| Employer 90/40 | $82 | 296% |
| Central Ca Indian Health | $112 | 404% |
| Nx Health Network Ppo | $112 | 404% |
| Healthsmart | $139 - $163 | 501% |
| Coventry Health Care (First Health Network) | $153 | 552% |
| Network By Design | $153 | 552% |
| Generic Multiplan | $173 | 624% |
| Phcs | $173 | 624% |
| Physmetrics Health | $285 | 1028% |