CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: John Muir Medical Center - Concord Campus

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $122
  • Cash Discount Price: $109
  • vs. Medicare Baseline: 4.40x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at John Muir Medical Center - Concord Campus is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.40x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$109

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $109 (393%)
Insurance Median: $122 (440%)
Cash: $109 (393% of Medicare)
Ins. Median: $122 (440% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 440% of the Medicare baseline (a markup of 340%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Contra Costa County Jail [1012104] $22 79%
Jmpn Canopy Hn [1640000011] $30 108%
UnitedHealthcare $30 - $142 108%
Health Net-Network Mcare [1028127] $33 119%
Aetna $34 - $180 123%
Alignment Health [1177113] $34 123%
Blue Cross Blue Shield $34 - $504 123%
Care 1St Health Plan [1094113] $34 123%
Caremore [1171113] $34 123%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $34 123%
Easy Choice Health Plan [1083113] $34 123%
Essence Healthcare [1049028] $34 123%
Essence Healthcare [1049128] $34 123%
Generic Commercial/Indemnity [1017001] $34 - $97 123%
Generic Hmo [1018103] $34 123%
Generic Ppo [1021104] $34 123%
Golden State-Network Mcare [1023127] $34 123%
Hospice Of East Bay [1085104] $34 123%
Humana $34 - $202 123%
Medicare (plans) $34 - $195 123%
Scan-Network Mcare [1043127] $34 123%
Tricare $34 123%
Veterans Administration [1051113] $34 123%
Workers' Comp [1024005] $40 144%
Canopy Hn Hmo [1166103] $62 224%
Carecentrix [1011001] $97 350%
Aps Healthcare [1003103] $109 393%
United Behavioral Health [1048103] $122 440%
Cigna $124 - $174 447%
Carelon Behavioral Health [1050104] $134 483%
Fortified Provider Network [1063104] $134 483%
Medigap [1036001] $134 483%
Three Rivers Provider Network [1073104] $134 483%
Health Net Hmo [1028103] $139 501%
Health Net-Network [1028026] $139 501%
Contra Costa Health Plan Hmo [1013103] $146 527%
Blue Shield Hmo [1006103] $151 - $154 545%
Blue Shield-Network [1006026] $154 556%
Blue Shield Ppo [1006104] $162 - $179 584%
Western Health Advantage Hmo [1053103] $170 - $195 613%
Health Net Ppo [1028104] $177 639%
Kaiser Hmo [1033103] $180 649%
Federal Correction Institute [1062104] $195 703%
First Health [1016104] $195 - $207 703%
Healthsmart - Pka Interplan [1031104] $195 703%
Networks By Design [1084104] $195 703%
Pponext [1072104] $195 703%
Sutter Preferred Health Plan [1044104] $195 703%
Health Management Network [1066104] $207 747%
Healthcomp [1089104] $207 - $418 747%
Galaxy Health Network [1064104] $219 790%
Integrated Health Plan [1075104] $219 790%
Brms [1091104] $418 1508%
Delta Health Systems [1032104] $418 1508%
Empire Plan [1092104] $418 1508%
Donor Network West [1008103] $12,000 43290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2540 East St, Concord, CA 94520
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals