CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Valley Children's Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $132
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.76x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Valley Children's Hospital is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.76x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$132

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%)
Insurance Median: $132 (476%)
Ins. Median: $132 (476% 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 476% of the Medicare baseline (a markup of 376%). 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
Allcare Ipa $32 - $120 115%
Community Care Ipa $32 - $50 115%
Kaiser $32 - $156 115%
Dignity Ipa_Formerly Img $45 162%
La Salle Ipa $45 162%
Sante Ipa $45 162%
Central Valley Medical Providers Ipa $48 - $120 173%
Sequoia Health Ipa $48 173%
Univseral Healthcare Ipa $48 173%
United Physicians Network Ipa $49 - $120 177%
Adventist $56 202%
Blue Cross Blue Shield $58 - $719 209%
Cencal Health $63 227%
Kern Family Health Care $64 231%
Central California Alliance For Health $65 234%
Health Net $84 - $157 303%
Dignity Health Central Coast $119 429%
Community Health $132 476%
Stanislaus Partners In Health $132 476%
Physicians Choice Medical Group $134 483%
Health Plan Of San Joaquin $144 519%
Fowler Packing $149 538%
Dignity (Formerly Managed Care Systems) $151 545%
Kern Legacy $156 563%
Blue Shield $160 - $182 577%
Aetna $161 581%
UnitedHealthcare $161 - $171 581%
First Health Formerly Coventry $178 642%
Bakersfield Family Medical Group $180 649%
Network By Design $186 671%
Community Care Health Plan $192 693%
Health Smart $192 693%
Key Medical Ipa $192 693%
Sutter Health $204 736%
Multiplan $230 830%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens