CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $33
Cash Discount Price: $163
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Shriners Hospitals for Children Northern Calif is $33. 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 1.19x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$163

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $33 (119%)

Cash: $163 (588% of Medicare)

Ins. Median: $33 (119% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$27 - $29	97%
Ambetter / Centene	$27 - $33	97%
Molina Healthcare Of Ms	$27	97%
Northbay Healthcare	$29	105%
Amerihealth Caritas Nc	$31	112%
Amerihealth Caritas Sc	$31	112%
Caresource Of Oh	$31	112%
Sutter Medical Foundation	$32	115%
Health Net Of Ca	$33	119%
Sana Benefits	$37 - $41	133%
Kaiser Permanente	$100	361%
Blue Cross Blue Shield	$113 - $307	408%
Cigna	$130	469%
Providence Health Plan	$139	501%
UnitedHealthcare	$167 - $183	602%
Dignity Health	$233	841%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $163.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Shriners Hospitals for Children Northern Calif is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.