CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Coastal Communities Hospital
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $45
- Cash Discount Price: $169
- vs. Medicare Baseline: 1.62x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Coastal Communities Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.62x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$169
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: $169 (610%)
Insurance Median: $45 (162%)
Cash: $169 (610% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kpc Healthcare Inc | $27 - $45 | 97% |
| Altamed Health Services | $29 - $45 | 105% |
| Champus | $29 | 105% |
| Blue Shield | $31 - $117 | 112% |
| Caloptima | $31 - $45 | 112% |
| Central Health Plan Of California | $31 | 112% |
| Champion Health Plan | $31 | 112% |
| Choice Physicians Network | $31 | 112% |
| Citizens Choice Health Plan | $31 | 112% |
| Clever Care Health Plan | $31 | 112% |
| Easy Choice Health Plan | $31 | 112% |
| For Your Benefit | $31 | 112% |
| Health Net | $31 - $123 | 112% |
| Healthcare Partners Sr Hmo | $31 | 112% |
| Heritage | $31 | 112% |
| Hollywood Presbyterian | $31 - $32 | 112% |
| Humana | $31 | 112% |
| Imperial Health Plan Of Ca | $31 | 112% |
| Innovative Integrated Health | $31 | 112% |
| Kaiser | $31 - $104 | 112% |
| Medcare Partners | $31 | 112% |
| Monarch | $31 - $167 | 112% |
| Onecare | $31 | 112% |
| Onecare Connect | $31 | 112% |
| Other Senior Non Contract | $31 | 112% |
| Prospect Health Plan | $31 - $46 | 112% |
| Scan Health Plan | $31 | 112% |
| Self Pay Ab774/Cbo Use Only | $31 | 112% |
| UnitedHealthcare | $31 - $220 | 112% |
| Us Dept Of Labor | $31 | 112% |
| Us Federal Marshall/Department Of Immigration | $31 | 112% |
| Velocity Provider Network Sr | $31 | 112% |
| Verda Health Plan Sr | $31 | 112% |
| Veterans Administration | $31 | 112% |
| Victim Of Violent Crime | $31 | 112% |
| Victoria Hospice | $31 | 112% |
| Altamed Mcal Hmo (Ancillary) | $32 | 115% |
| Healthcare Partners | $32 | 115% |
| Medi-Cal Hmo/Non Contract | $32 | 115% |
| Medicaid / KanCare | $32 | 115% |
| Brand New Day | $34 | 123% |
| Prime Health Srvs | $35 - $135 | 126% |
| County Of Orange/Custody/Advanced Medmgt | $38 | 137% |
| Veterans Evaluation Services | $38 | 137% |
| Coventry Auto Network | $40 | 144% |
| Interplan | $40 - $127 | 144% |
| Prime Health Srvs/Wc | $40 | 144% |
| Coventry Wc | $41 | 148% |
| Multiplan | $43 - $118 | 155% |
| Staywell/Island Home Ins | $43 | 155% |
| Three Rivers | $43 | 155% |
| Velocity National Provider Network Wc | $44 | 159% |
| Workers Comp State Of California | $44 | 159% |
| Choc Health Alliance | $45 | 162% |
| County Of Orange | $45 | 162% |
| Family Choice | $45 | 162% |
| Heritage Provider Network | $45 - $101 | 162% |
| Ihhi Reciprocity | $51 | 184% |
| Three Rivers Network | $54 | 195% |
| Velocity National Provider Network Ppo | $54 | 195% |
| Aetna | $55 | 198% |
| First Health | $89 | 321% |
| Magellan | $101 | 364% |
| Cigna | $110 - $315 | 397% |
| Networks By Design | $118 | 426% |
| Networks By Design Wc | $118 | 426% |
| Healthsmart | $127 | 458% |
| Prime Health | $127 | 458% |
| Pnoa-Provider Network Of America | $135 | 487% |
| Prime Health Srvs/Network | $144 | 519% |
| Lucet Behavioral Health Sr | $169 | 610% |
| Managed Health Network | $169 | 610% |
| Other Insurance Loa | $169 | 610% |
| Other Non Contracted Plans | $169 | 610% |
| Private Pay | $169 | 610% |
| Us Behavioral Health Plan | $169 | 610% |
| Vitas Hospice | $169 | 610% |
| Monarch Health Plan | $179 | 646% |