CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Boulder Community Health

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $105
  • Cash Discount Price: $139
  • vs. Medicare Baseline: 3.79x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Boulder Community Health is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.79x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$139

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $139 (501%)
Insurance Median: $105 (379%)
Cash: $139 (501% of Medicare)
Ins. Median: $105 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Humana $19 - $28 69%
Blue Cross Blue Shield $27 - $165 97%
Aetna $28 - $241 101%
Devoted Health $28 - $111 101%
Health Spring $28 - $60 101%
Medicare (plans) $28 - $105 101%
UnitedHealthcare $28 - $418 101%
Clear Spring $29 105%
Rocky Mountain Health Maintenance Organization $29 - $219 105%
Medicaid / KanCare $30 108%
Kaiser Ppo $33 - $66 119%
Kaiser Public Option $33 - $54 119%
Select Health Colorado Public Option $33 - $105 119%
Select Health Value Network $33 - $105 119%
Cigna $34 - $246 123%
Colorado Access $34 - $40 123%
Beech Street Community Medical Associates $42 152%
Multiplan $44 - $194 159%
Phcs $44 - $194 159%
Kaiser $65 234%
Rocky Mountain Health Maintenance Organization Private Plan $194 700%
Integrated Health Plans Bch $208 750%
Casualty Management Network, Prime Health Services Behavioral Health $235 848%
Mines And Associates $235 848%
Three Rivers Provider Network $235 848%
Zelis (Profee) $235 848%
Casualty Management Network, Prime Health Services Community Medical Associates $249 898%
National Preferred Provider Network $249 898%
Rockport Healthcare Group Community Medical Associates $249 898%
Usa $249 898%
Rockport Healthcare Group Bch $258 931%
Health Payors Organization $263 949%
Health Management Network Bch Community Medical Associates $266 960%
Health Management Network Community Medical Associates $266 960%
National Provider Network $269 970%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals