CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Scripps Memorial Hospital - Encinitas
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $54
- Cash Discount Price: $39
- vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Scripps Memorial Hospital - Encinitas is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.95x the Medicare baseline. Located in 354 Santa Fe Drive, Encinitas, CA.
Cash / Self-Pay
$39
Average discount available for prompt cash payment at this facility.
Insurance Median
$54
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: $39 (141%)
Insurance Median: $54 (195%)
Cash: $39 (141% of Medicare)
Ins. Median: $54 (195% 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 |
|---|---|---|
| Radys Cpmg [803] | $11 - $20 | 40% |
| Blue Cross Blue Shield | $30 - $66 | 108% |
| Aetna | $31 - $127 | 112% |
| Alignment Health Plan [443] | $31 | 112% |
| Astiva Mcr Adv [464] | $31 | 112% |
| Bc Mcr Adv [830] | $31 | 112% |
| Bc [814] | $31 - $56 | 112% |
| Bs Mcr Adv [829] | $31 | 112% |
| Central Health Mcr Adv [441] | $31 | 112% |
| Cigna | $31 - $99 | 112% |
| Clever Care Mcr Adv [465] | $31 | 112% |
| D-Snp Mcr Adv [889] | $31 | 112% |
| Dsnp/Csnp - Generic [458] | $31 | 112% |
| Family Health Centers Pace Mcr Adv Hmo [556] | $31 | 112% |
| Family Health Centers Pace Medi-Cal [555] | $31 | 112% |
| Gary And Mary West Pace Medi-Cal Hmo [557] | $31 | 112% |
| Gpmg/Altura - Mcr Adv [888] | $31 | 112% |
| Hn Mcr Adv [832] | $31 | 112% |
| Humana | $31 | 112% |
| Imperial County Phys Med Group [855] | $31 - $86 | 112% |
| Integrated Health Partners - Mcr Adv [895] | $31 | 112% |
| Integrated Health Partners [894] | $31 - $56 | 112% |
| Kaiser Northern Ca Region Mcr Adv [386] | $31 | 112% |
| La Care Mcr Adv Hmo [612] | $31 | 112% |
| Medicare (plans) | $31 | 112% |
| Mpmg Mcr Adv [836] | $31 | 112% |
| Mpmg [800] | $31 | 112% |
| Ocn Mcr Adv [890] | $31 | 112% |
| Perlman Med Group [899] | $31 - $56 | 112% |
| San Diego Pace Medi-Cal [553] | $31 | 112% |
| Scan Mcr Adv [835] | $31 | 112% |
| Scan [500] | $31 | 112% |
| Scan [818] | $31 | 112% |
| Sharp Comm Med Grp Mcr Adv [840] | $31 | 112% |
| Sharp Comm Med Grp [812] | $31 - $114 | 112% |
| Sharp Health Plan Mcr Adv [531] | $31 | 112% |
| Sharp Health Plan Mcr Adv [897] | $31 | 112% |
| Sharp Rees Stealy Med Grp Mcr Adv [841] | $31 | 112% |
| Sharp Rees Stealy Med Grp [811] | $31 - $114 | 112% |
| St Paul'S Pace Medi-Cal [551] | $31 | 112% |
| Ucsd Mcr Adv [873] | $31 | 112% |
| Ucsd [807] | $31 - $114 | 112% |
| Uh Mcr Adv [831] | $31 | 112% |
| Uh Palomar Health Mcr Adv [885] | $31 | 112% |
| UnitedHealthcare | $31 - $88 | 112% |
| Centivo [581] | $33 - $58 | 119% |
| Blue Shield [230] | $47 - $90 | 170% |
| Bs [816] | $48 - $89 | 173% |
| Health Net [340] | $48 - $84 | 173% |
| Hn [815] | $48 - $84 | 173% |
| Uh [819] | $50 - $88 | 180% |
| Prime Healthcare [614] | $52 | 188% |
| Prospect Med Group [893] | $53 | 191% |
| Rady Children'S Hospital [825] | $58 - $103 | 209% |
| Mc Alignment [917] | $59 | 213% |
| Mc Blue Shield Promise Health Plan [914] | $59 | 213% |
| Mc Blue Shield [902] | $59 | 213% |
| Mc Health Net [904] | $59 | 213% |
| Mc Scan [905] | $59 | 213% |
| Mc United [906] | $59 | 213% |
| Palomar Health [892] | $64 - $114 | 231% |
| Veba Med Grp [813] | $64 - $114 | 231% |
| Kaiser Northern Ca Region Hmo/Ppo [384] | $81 - $143 | 292% |
| Kaiser [380] | $81 - $143 | 292% |
| Kaiser [383] | $81 - $143 | 292% |
| Multi Plan Network [470] | $101 - $178 | 364% |
| First Health Network [330] | $106 - $188 | 382% |
| Pnoa [615] | $106 - $188 | 382% |
| Choice Care Network [270] | $113 - $201 | 408% |
| Healthsmart [350] | $113 - $201 | 408% |